Active NPI
Ortho 360 LLC
- Orthodontics and Dentofacial Orthopedics Dentistry
- Kenosha, WI
National Provider Identifier
1831001825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- Legal business name
- ORTHO 360 LLC
- Practice address
- 3726 Roosevelt Rd
Kenosha, WI 53142-1900 - Phone
- (877) 786-0360
- NPI assigned
- Sep 22, 2026
- Last updated
- Sep 22, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ivana Bueno
- Title
- Director
- Phone
- (773) 798-9382
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | NU | Primary |
Addresses
Primary practice location
3726 Roosevelt Rd
Kenosha, WI 53142-1900
Mailing address
3726 Roosevelt Rd
Kenosha, WI 53142-1900
Phone (877) 795-0360
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790035200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790035200000",
"number": "1831001825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3726 ROOSEVELT RD",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531421900",
"telephone_number": "877-795-0360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3726 ROOSEVELT RD",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531421900",
"telephone_number": "877-786-0360"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ORTHO 360 LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-22",
"last_updated": "2026-09-22",
"certification_date": "2026-09-22",
"status": "A",
"authorized_official_last_name": "BUENO",
"authorized_official_first_name": "IVANA",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "773-798-9382"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NU",
"license": null,
"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 Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.