Individual provider Active NPI

Margaret Aboagye, DDS

  • General Practice Dentistry
  • Racine, WI
National Provider Identifier
1629150289
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1295G Issued in WI
Practice address
400 Lake Ave
Racine, WI 53403-1020
Phone
(262) 633-0775
Fax
(262) 632-0925
NPI assigned
Oct 20, 2006
Last updated
Sep 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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 1295G WI Primary

Addresses

Primary practice location

400 Lake Ave
Racine, WI 53403-1020

Mailing address

400 Lake Ave
Racine, WI 53403-1020
Phone (262) 633-0775

Other identifiers 1

IdentifierTypeStateIssuer
33605400MedicaidWI

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
1295GWIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
911 Dental Group CurrentSince Feb 23, 2025 Accepting new patients
Lake Dental Group Past Accepting new patients

Locations

400 Lake Ave
Racine, WI 53403
Phone (262) 633-0775

Organizations & group practices 3

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1629150289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 LAKE AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031020",
            "telephone_number": "262-633-0775",
            "fax_number": "262-632-0925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 LAKE AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031020",
            "telephone_number": "262-633-0775",
            "fax_number": "262-632-0925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOAGYE",
        "first_name": "MARGARET",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1295G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33605400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.