Individual provider Active NPI

Randy R Ciepluch, DDS

  • Dentist
  • Milwaukee, WI
National Provider Identifier
1245221977
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2260-015 Issued in WI
Practice address
3500 W Lisbon Ave
Milwaukee, WI 53208-1953
Phone
(414) 342-0378
Fax
(414) 342-1008
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2260-015 WI Primary

Addresses

Primary practice location

3500 W Lisbon Ave
Milwaukee, WI 53208-1953

Mailing address

3500 W Lisbon Ave
Milwaukee, WI 53208-1953
Phone (414) 342-0378

Other identifiers 1

IdentifierTypeStateIssuer
33387500MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2260-015WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Randy R Ciepluch DDS Past Accepting new patients
Randy R Ciepluch Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1245221977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 W LISBON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532081953",
            "telephone_number": "414-342-0378",
            "fax_number": "414-342-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 W LISBON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532081953",
            "telephone_number": "414-342-0378",
            "fax_number": "414-342-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIEPLUCH",
        "first_name": "RANDY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "2260-015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33387500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.