NPIMap

Organization Active NPI

Dental Care Providers of America

  • Dental Clinic/Center
  • Kenosha, WI
National Provider Identifier
1104207232
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
1001058-15 Issued in WI
Legal business name
DENTAL CARE PROVIDERS OF AMERICA
Doing business as
Dental Care of Kenosha
Practice address
3715 Washington Rd
Kenosha, WI 53144-1629
Phone
(262) 237-6238
NPI assigned
Jun 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. William Ryan Kisker, D.M.D.
Title
President
Phone
(224) 645-4929

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 1001058-15 WI Primary

Addresses

Primary practice location

3715 Washington Rd
Kenosha, WI 53144-1629

Mailing address

PO Box 788
Kenosha, WI 53141-0788
Phone (262) 842-2877

Other names 1

  • Dental Care of Kenosha Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Care of Kenosha2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3715 Washington Rd
Kenosha, WI 53144
Phone (262) 237-6238

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1104207232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531410788",
            "telephone_number": "262-842-2877",
            "fax_number": "877-725-4332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 WASHINGTON RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531441629",
            "telephone_number": "262-237-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL CARE PROVIDERS OF AMERICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "KISKER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "224-645-4929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WI",
            "license": "1001058-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care of Kenosha",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.