Kenneth Peter Sobczak, DDS

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

5001194 Issued in WI

Practice address

5000 W National Ave
Milwaukee, WI 53295-0001

Phone

(414) 384-2000

NPI assigned

Jul 14, 2006

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 21, 2016 through Jun 21, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225054265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 CHANCEL CT",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531512396",
            "telephone_number": "262-641-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 W NATIONAL AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532950001",
            "telephone_number": "414-384-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBCZAK",
        "first_name": "KENNETH",
        "middle_name": "PETER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "WI",
            "license": "5001194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Snyder, MS, LPC, SAC-IT
• Vanessa A Snyder, PSYD
• Ana P Soares-Lynch, CPC
• Rebecca L Sobanski, APNP, PMHNP-BC
• Jacob Andrew Sobczak, COTA
• Linda Sobczyk, RN
• Michael Frederic Sobin, MD
• W Harley Sobin, MD
• Patrycja Sobolak, DPT
• Kelly Victoria Sobrado, MSW

• Prosthodontics in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Prosthodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.