Erin Dawn Kallsen

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

6001153-15 Issued in WI

Practice address

125 Siegler St
Green Bay, WI 54303-2635

Phone

(920) 592-8940

NPI assigned

Apr 5, 2023

Last updated

Aug 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kids Dental Experts Partnership, LLC

  dba Kids Dental Experts

  • Pediatric Dentistry
  • Green Bay, WI
  • NPI 1730397233
  NPD

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

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1245935428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 SIEGLER ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032635",
            "telephone_number": "920-592-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SIEGLER ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032635",
            "telephone_number": "920-592-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLSEN",
        "first_name": "ERIN",
        "middle_name": "DAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-05",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WI",
            "license": "6001153-15",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jace Iokepa Kaikuaana, PT
• Naciye Kalafat, M.D.
• Ally Elizabeth Kalkofen, APNP, FNP-BC
• Melissa Ann Kallie
• Danielle Kallin
• Esmaeil Ben Kamali, FNP
• Steven Edward Kaminski, DDS
• Thomas E Kaminski, DMD
• George J Kamps, MSW,ACSW, LCSW
• Stephanie Ann Kamstra, CRNA

• Pediatric Dentistry in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Pediatric Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; 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.