Active NPI
Brian Patrick Chybowski, DDS
- General Practice Dentistry
- Kenosha, WI
National Provider Identifier
1285641654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4957
- Practice address
- 7117 Green Bay Rd
Kenosha, WI 53142-1450 - Phone
- (262) 942-7000
- Fax
- (262) 942-7117
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4957 | WI | Primary |
Addresses
Primary practice location
7117 Green Bay Rd
Kenosha, WI 53142-1450
Mailing address
1030 W Willow Dr
Oak Creek, WI 53154-2839
Phone (414) 764-4783
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4957 | WI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Associates LTD of Wisconsin | General Practice | 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": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285641654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1030 W WILLOW DR",
"city": "OAK CREEK",
"state": "WI",
"postal_code": "531542839",
"telephone_number": "414-764-4783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7117 GREEN BAY RD",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531421450",
"telephone_number": "262-942-7000",
"fax_number": "262-942-7117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHYBOWSKI",
"first_name": "BRIAN",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "4957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenosha, WI
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.