Kelley Marie Dentino, D.M.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

1001985-15 Issued in WI

Practice address

W178N9201 Water Tower PL
Menomonee Falls, WI 53051-8044

Phone

(262) 251-8704

NPI assigned

Sep 3, 2014

Last updated

Jun 8, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dentino Dental Specialists

  dba Dentino Pediatric Dentistry and Orthodontics

  • Pediatric Dentistry
  • Brookfield, WI
  • NPI 1285529925

  Orthodontics and Dentofacial Orthopedics

  NPD
• Ridgeview Dental Group SC

  • General Practice Dentistry
  • Menomonee Falls, WI
  • NPI 1437236536
  NPD (past)

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749340800000",
    "number": "1609276120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W178N9201 WATER TOWER PL STE 100",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530518045",
            "telephone_number": "262-251-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W178N9201 WATER TOWER PL",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530518044",
            "telephone_number": "262-251-8704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Longwood Ave",
            "address_2": "Department of Plastic & Oral Surgery",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155724",
            "country_code": "US",
            "telephone_number": "414-861-0912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENTINO",
        "first_name": "KELLEY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-03",
        "last_updated": "2025-06-08",
        "certification_date": "2025-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1856732",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WI",
            "license": "1001985-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Dehn, LAT
• Michael Allan Delatorre, M.D.
• Mary Lewis Delcore, P.T.
• Mario F Deluca, HIS
• Kristina Denter, PHARM D
• Luke V Desjarlais, PAC
• Miranda R Dethier, PA-C
• Mindy May Deura, BSN, RN, CDCES
• Stacey M. Deutsch, R.D.
• Michelle Dickau, RD

• Orthodontics and Dentofacial Orthopedics Dentistry in Menomonee Falls, WI
• Providers in Menomonee Falls, 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 Jun 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.