Individual provider Active NPI

Kenya Michelle McCalebb, D.D.S.

  • Dentist
  • Milwaukee, WI
National Provider Identifier
1295182285
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
100123115 Issued in WI
Practice address
1550 N Edison St
Apartment 205
Milwaukee, WI 53202-3166
Phone
(773) 587-6182
NPI assigned
May 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 100123115 WI Primary

Addresses

Primary practice location

1550 N Edison St
Apartment 205
Milwaukee, WI 53202-3166

Mailing address

1550 N Edison St
Apartment 205
Milwaukee, WI 53202-3166
Phone (773) 587-6182

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
100123115WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1295182285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 N EDISON ST",
            "address_2": "APARTMENT 205",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023166",
            "telephone_number": "773-587-6182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 N EDISON ST",
            "address_2": "APARTMENT 205",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023166",
            "telephone_number": "773-587-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALEBB",
        "first_name": "KENYA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-19",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "100123115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; 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.