Kristin Lynn Osgood Kotlewski, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4902 Issued in WI

Practice address

10155 Washington Ave
Sturtevant, WI 53177-1645

Phone

(262) 884-3011

Fax

(262) 664-7799

NPI assigned

Jul 5, 2006

Last updated

Dec 18, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kristin L Osgood Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 29, 2021 through Jun 29, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dental Associates LTD of Wisconsin

  • Endodontics
  • Wauwatosa, WI
  • NPI 1518266998

  General Practice

  NPD (past)
• Racine Dental Center LLC

  • Dentist
  • Racine, WI
  • NPI 1932814670
  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1316978026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4554 W ALESCI DR",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531328170",
            "telephone_number": "414-423-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10155 WASHINGTON AVE",
            "city": "STURTEVANT",
            "state": "WI",
            "postal_code": "531771645",
            "telephone_number": "262-884-3011",
            "fax_number": "262-664-7799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11711 W Burleigh St",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "532223108",
            "country_code": "US",
            "telephone_number": "414-771-2345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSGOOD KOTLEWSKI",
        "first_name": "KRISTIN",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "4902",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "4902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33742300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "OSGOOD",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Janice A Litza, MD
• Anthony Lotesto, DMD
• Lucy McAuley, PT
• David L Nichols, PHD
• Omni Human Performance Consulting
• Sabrina G Philip, D.D.S.
• Todd Edward Pienkos, DDS
• Pillpack LLC
• Psychiatric Services of Racine, LLP
• Racine Digestive Health Center LLC

• General Practice Dentistry in Sturtevant, WI
• Providers in Sturtevant, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.