Dental Health Professionals of Wisconsin, S.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTAL HEALTH PROFESSIONALS OF WISCONSIN, S.C.

Practice address

4445 Taylor Ave Ste 1
Mount Pleasant, WI 53405-4642

Phone

(262) 554-1600

NPI assigned

Feb 10, 2021

Organization subpart

Yes

Parent organization

DENTAL HEALTH PROFESSIONALS OF WISCONSIN, S.C.As reported in NPPES

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

Authorized official

Name

Hannah Fish

Title

Credentialing Manager

Phone

(217) 540-5699

Specialties & licenses 1

Addresses

Other names 1

• Kind Dentistry Doing business as

Part of

Dental Health Professionals of Wisconsin SC

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly A Kind-Bauer, DDS

  • Dentist
  • Racine, WI
  • NPI 1023244159
  NPD (past)
• William L Bacon, DDS

  • Dentist
  • Gurnee, IL
  • NPI 1073643052
  NPD (past)

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1417549544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 TAYLOR AVE STE 1",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534054642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 TAYLOR AVE STE 1",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534054642",
            "telephone_number": "262-554-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL HEALTH PROFESSIONALS OF WISCONSIN, S.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL HEALTH PROFESSIONALS OF WISCONSIN, S.C.",
        "enumeration_date": "2021-02-10",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A",
        "authorized_official_last_name": "FISH",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "217-540-5699"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kind Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kind Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joshua Delarosa, MPAS, PA-C
• Lesley Delgado, M.D.
• Angela Dellise, LPC, CSAC, CS-IT
• Barbara Gail Demilio, LCSW
• Denise Falaschi LPC Inc
• Dermatology Consultants LLC
• Michael Derose, LCSW
• Developmental Disabilities Information Service, Inc.
• Yagya Dhakal, MD
• Diabetes Osteoporosis Thyroid Endocrine Center, LLC

• All providers in Mount Pleasant, WI
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.