Mark R Kenfield, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

500207 Issued in WI

Practice address

1320 S Greenbay Rd
Racine, WI 53406-4406

Phone

(262) 637-9371

NPI assigned

Mar 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 6, 2018 through Jun 6, 2028

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 and National Provider Directory roles.

• Racine Dental Center LLC

  • Dentist
  • Racine, WI
  • NPI 1932814670
  NPD (past)
• Racine Dental Group S C

  • Dentist
  • Racine, WI
  • NPI 1801941570

  General Practice

  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649309121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 S GREENBAY RD",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534064406",
            "telephone_number": "262-637-9371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 S GREENBAY RD",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534064406",
            "telephone_number": "262-637-9371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENFIELD",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "500207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33384700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Thomas Keil, R.PH
• Denise A Keller, COTA
• Karl Thomas Keller, DC
• Wendy Carroll Kelly
• Richard John Kemper, DDS
• Kenosha Community Health Center, Inc.
• Adel Khdour, MD
• Abigail Kibler
• Cynthia Ann Kickland
• Janet E. Kieslich, N.P.

• General Practice Dentistry in Racine, WI
• Providers in Racine, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.