Individual provider Active NPI

Jeffrey Romanski

  • General Practice Dentistry
  • Racine, WI
National Provider Identifier
1710044243
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5002023 Issued in WI
Practice address
6218 Washington Ave
Suite C
Racine, WI 53406-3916
Phone
(262) 886-1300
Fax
(262) 886-1837
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5002023 WI Primary

Addresses

Primary practice location

6218 Washington Ave
Suite C
Racine, WI 53406-3916

Mailing address

6218 Washington Ave
Suite C
Racine, WI 53406-3916
Phone (262) 886-1300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20160105001826 WI Order and Referring Only - DentistPractitioner - Dentist 2567764764

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5002023WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Deerwood Orthodontics, LLC PastSince Mar 20, 2022 Accepting new patients
Wisconsin Dental Group, S.C. General Practice Past Accepting new patients

Organizations & group practices 2

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710044243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6218 WASHINGTON AVE",
            "address_2": "SUITE C",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534063916",
            "telephone_number": "262-886-1300",
            "fax_number": "262-886-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6218 WASHINGTON AVE",
            "address_2": "SUITE C",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534063916",
            "telephone_number": "262-886-1300",
            "fax_number": "262-886-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANSKI",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5002023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

Verify at the official NPI Registry.