Youngquist Kennedy Orthodontics, LTD.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

6951-15 Issued in WI

Legal business name

YOUNGQUIST KENNEDY ORTHODONTICS, LTD.

Practice address

255 Havenwood Dr
Lake Geneva, WI 53147-1917

Phone

(262) 248-0101

Fax

(262) 248-2941

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Robert R. Youngquist, D.D.S.

Title

President

Phone

(262) 248-0101

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506297600000",
    "number": "1346339595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 HAVENWOOD DR",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471917",
            "telephone_number": "262-248-0101",
            "fax_number": "262-248-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 HAVENWOOD DR",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471917",
            "telephone_number": "262-248-0101",
            "fax_number": "262-248-2941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNGQUIST KENNEDY ORTHODONTICS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2017-09-25",
        "status": "A",
        "authorized_official_last_name": "YOUNGQUIST",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-248-0101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WI",
            "license": "2191B",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WI",
            "license": "6951-15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33395900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Wisnowski, PHARMD
• Amanda Wolf, APNP
• Katelyn M Woolbright, DPT
• Amanda Joleen Young
• Deborah Lynn Young, APRN, FNP
• Robert Youngquist
• Cynthia L. Yurczyk-Campbell, MSOM, LAC, CMT
• Albert J Zambito, D.D.S.
• Joy Zerrudo Seldera, MD
• Tara Zimmerman

• Orthodontics and Dentofacial Orthopedics Dentistry in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2017; 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.