Individual provider Active NPI

Alice Zheng

  • General Practice Dentistry
  • Kenosha, WI
National Provider Identifier
1730934951
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6001590 Issued in WI
Practice address
7117 Green Bay Rd
Kenosha, WI 53142-1450
Phone
(262) 942-7000
NPI assigned
Apr 22, 2024
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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 6001590 WI Primary

Addresses

Primary practice location

7117 Green Bay Rd
Kenosha, WI 53142-1450

Mailing address

11711 W Burleigh St
Wauwatosa, WI 53222-3196
Phone (414) 771-2345

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
6001590WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Associates LTD of Wisconsin General Practice CurrentSince Jul 21, 2024 Accepting new patients

Locations

7117 Green Bay Rd
Kenosha, WI 53142
Phone (262) 942-7000

11711 W Burleigh St
Wauwatosa, WI 53222
Phone (414) 771-2345

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, 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": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1730934951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11711 W BURLEIGH ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532223196",
            "telephone_number": "414-771-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 GREEN BAY RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531421450",
            "telephone_number": "262-942-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHENG",
        "first_name": "ALICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6001590",
            "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 10, 2024; 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.