Individual provider Active NPI

John M Lindell, DDS

  • Endodontics
  • Kenosha, WI
National Provider Identifier
1598047003
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
600005015 Issued in WI
Practice address
5021 Washington Rd
Kenosha, WI 53144-4292
Phone
(262) 632-5455
NPI assigned
Sep 12, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019028840 IL
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X 600005015 WI Primary

Addresses

Primary practice location

5021 Washington Rd
Kenosha, WI 53144-4292

Mailing address

1209 Valley View Dr
Mt Pleasant, WI 53405-1738
Phone (775) 336-9198

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180810000894 MI Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 8022366806

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
600005015WIMDEndodontist
019028840ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1315785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1598047003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 VALLEY VIEW DR",
            "city": "MT PLEASANT",
            "state": "WI",
            "postal_code": "534051738",
            "telephone_number": "775-336-9198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5021 WASHINGTON RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531444292",
            "telephone_number": "262-632-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDELL",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-12",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028840",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "WI",
            "license": "600005015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.