Tejpal Singh Athwal, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1002315 Issued in WI

Practice address

5707 75TH St
Kenosha, WI 53142-3603

Phone

(262) 697-0321

NPI assigned

Jun 17, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Kenosha Family Dentistry

  • General Practice Dentistry
  • Kenosha, WI
  • NPI 1033941067
  NPD Authorized official
• Susan M. Cable, DDS, SC

  • General Practice Dentistry
  • Kenosha, WI
  • NPI 1427735463
  NPD

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1164048047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5707 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423603",
            "telephone_number": "262-697-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5707 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423603",
            "telephone_number": "262-697-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATHWAL",
        "first_name": "TEJPAL",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-17",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1002315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Samantha Jane Atkielski
• Kim Ann Augustine, 112279-030
• Aurora Cancer Care of Kenosha LLC
• Aurora Health Care Southern Lakes, Inc.
• Aurora Health Care Ventures Inc

• General Practice Dentistry in Kenosha, WI
• Providers in Kenosha, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; 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.