NPIMap

Individual provider Active NPI

Kyle Garro, D.D.S.

  • General Practice Dentistry
  • Twin Lakes, WI
National Provider Identifier
1124431887
Registry record updated Jun 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7259-15 Issued in WI
Practice address
330 E Main St
Twin Lakes, WI 53181-9682
Phone
(262) 877-2161
NPI assigned
Jun 10, 2014
Last updated
Jun 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7259-15 WI Primary

Addresses

Primary practice location

330 E Main St
Twin Lakes, WI 53181-9682

Mailing address

320 Alpine Meadow Cir
Oregon, WI 53575-3832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7259-15WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
KW Lake Mills LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1124431887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 ALPINE MEADOW CIR",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535753832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E MAIN ST",
            "city": "TWIN LAKES",
            "state": "WI",
            "postal_code": "531819682",
            "telephone_number": "262-877-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRO",
        "first_name": "KYLE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "7259-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Lakes, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.