Keith Douglas Clemence, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5001558 Issued in WI

Practice address

5751 S 108TH St
Hales Corners, WI 53130-1940

Phone

(414) 425-0120

Fax

(414) 425-0978

NPI assigned

Jun 7, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Keith D. Clemence, DDS

  • General Practice Dentistry
  • Hales Corners, WI
  • NPI 1710105630
  NPD (past) Authorized official

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1811937808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5751 S 108TH ST",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301940",
            "telephone_number": "414-425-0120",
            "fax_number": "414-425-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5751 S 108TH ST",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301940",
            "telephone_number": "414-425-0120",
            "fax_number": "414-425-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENCE",
        "first_name": "KEITH",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5001558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chiro One Wellness Center of Hales Corners, LLC
• Chiropractic Company - Greenfield West LLC
• Kay Carolyn Chmielewski, DPT
• Robert Chojnacki
• Colleen Alicia Christiansen, MS, LPC
• Mark A. Clemence, M.D.
• Andrwew John Collura, SAC-IT
• Alexis Colosimo, DDS
• Jason George Cooper
• Czaplicki Family Dentistry,S.C.

• General Practice Dentistry in Hales Corners, WI
• Providers in Hales Corners, 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 13, 2026; 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.