Individual provider Active NPI

Stephen Joseph Syrjamaki, D.D.S.

  • Dentist
  • Kenosha, WI
National Provider Identifier
1558624429
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6928-15 Issued in WI
Practice address
7117 Green Bay Rd
Kenosha, WI 53142-1450
Phone
(262) 942-7000
NPI assigned
Jun 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6928-15 WI Primary

Addresses

Primary practice location

7117 Green Bay Rd
Kenosha, WI 53142-1450

Mailing address

2121 S Webster Ave Ste 3
Green Bay, WI 54301-2290
Phone (920) 562-3736

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
6928-15WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Orchid Enterprises CurrentSince Jun 5, 2022 Accepting new patients
Dental Associates LTD of Wisconsin PastSince Feb 14, 2016 Accepting new patients

Locations

2121 S Webster Ave
Ste 3
Green Bay, WI 54301
Phone (920) 437-8017

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1339804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1558624429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 S WEBSTER AVE STE 3",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012290",
            "telephone_number": "920-562-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 GREEN BAY RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531421450",
            "telephone_number": "262-942-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYRJAMAKI",
        "first_name": "STEPHEN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-16",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6928-15",
            "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 1, 2022; 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.