Individual provider Active NPI

Rana R Muhson

  • General Practice Dentistry
  • Kenosha, WI
National Provider Identifier
1528744091
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6001228-15 Issued in WI
Practice address
6430 Green Bay Rd Ste 112
Kenosha, WI 53142-2948
Phone
(262) 653-3980
NPI assigned
Jun 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6001228-15 WI Primary

Addresses

Primary practice location

6430 Green Bay Rd Ste 112
Kenosha, WI 53142-2948

Mailing address

3220 Hill LN
Wilmette, IL 60091-2931
Phone (177) 321-7256

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
6001228-15WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Familia Dental Kenosha LLC General Practice CurrentSince Jul 2, 2023 Accepting new patients

Locations

6430 Green Bay Rd
Ste 112
Kenosha, WI 53142
Phone (262) 653-3980

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1528744091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 HILL LN",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912931",
            "telephone_number": "177-321-7256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6430 GREEN BAY RD STE 112",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531422948",
            "telephone_number": "262-653-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUHSON",
        "first_name": "RANA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6001228-15",
            "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 Jun 27, 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.