Individual provider Active NPI

Steven Steiner

  • General Practice Dentistry
  • Kenosha, WI
National Provider Identifier
1609553361
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6001266 Issued in WI
Practice address
6430 Green Bay Rd Ste 112
Kenosha, WI 53142-2948
Phone
(262) 653-3980
NPI assigned
Jul 3, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 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 6001266 WI Primary

Addresses

Primary practice location

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

Mailing address

330 Forsythia Dr
Deerfield, IL 60015-4604
Phone (224) 567-3556

Other practice location 1

3900 W Fullerton Ave
Chicago, IL 60647-2228
Phone (773) 252-8000

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
6001266WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Familia Dental Kenosha LLC General Practice CurrentSince Jul 9, 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1609553361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 FORSYTHIA DR",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154604",
            "telephone_number": "224-567-3556"
        },
        {
            "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": [
        {
            "address_1": "3900 W Fullerton Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606472228",
            "country_code": "US",
            "telephone_number": "773-252-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEINER",
        "first_name": "STEVEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6001266",
            "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 Jul 3, 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.