Individual provider Active NPI

Kenneth Sandler, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Appleton, WI
National Provider Identifier
1275701146
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
6002120 Issued in WI
Practice address
3030 N Ballard Rd
Appleton, WI 54911-8707
Phone
(201) 463-3233
NPI assigned
Feb 13, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 037164 NY
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 6002120 WI Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 021002928 IL

Addresses

Primary practice location

3030 N Ballard Rd
Appleton, WI 54911-8707

Mailing address

1110 Fox Glen Dr
St Charles, IL 60174-8840
Phone (201) 463-3233

Other practice location 1

2476 S Oneida St Ste 150
Green Bay, WI 54304-5292
Phone (201) 463-3233

Other practice location 2

1110 Fox Glen Dr
St Charles, IL 60174-8840
Phone (201) 463-3233

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
021002928ILMDOrthodontics and Dentofacial Orthopedic Dentist
037164NYMDOrthodontics and Dentofacial Orthopedic Dentist
6002120WIMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Perfect Smile Dental Office PC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1275701146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 FOX GLEN DR",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601748840",
            "telephone_number": "201-463-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 N BALLARD RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118707",
            "telephone_number": "201-463-3233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2476 S Oneida St Ste 150",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543045292",
            "country_code": "US",
            "telephone_number": "201-463-3233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1110 Fox Glen Dr",
            "address_purpose": "LOCATION",
            "city": "St Charles",
            "state": "IL",
            "postal_code": "601748840",
            "country_code": "US",
            "telephone_number": "201-463-3233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDLER",
        "first_name": "KENNETH",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-13",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "037164",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WI",
            "license": "6002120",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021002928",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; 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.