Individual provider Active NPI

Kenneth Dell Dembny II, M.D.

  • Plastic Surgery Physician
  • Wauwatosa, WI
National Provider Identifier
1851367585
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
35379020 Issued in WI
Practice address
201 N Mayfair Rd
Suite 530
Wauwatosa, WI 53226-4216
Phone
(414) 443-0033
Fax
(414) 443-0034
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 35379020 WI Primary

Addresses

Primary practice location

201 N Mayfair Rd
Suite 530
Wauwatosa, WI 53226-4216

Mailing address

13405 Juneau Blvd
Elm Grove, WI 53122-1723
Phone (262) 797-6176

Other identifiers 1

IdentifierTypeStateIssuer
33331000MedicaidWI

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040505000399 WI Practitioner - Plastic and Reconstructive Surgery 6709874027 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35379020WIMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CJ Hussussian MD SC Plastic Surgery CurrentSince Oct 5, 2019 Accepting new patients

Locations

6400 Industrial Loop
Greendale, WI 53129
Phone (414) 423-4100

N4W22370 Bluemound Rd
Ste 100
Waukesha, WI 53186
Phone (262) 970-5600

N4W22370 Bluemound Rd
Waukesha, WI 53186
Phone (262) 970-5600

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1851367585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13405 JUNEAU BLVD",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531221723",
            "telephone_number": "262-797-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N MAYFAIR RD",
            "address_2": "SUITE 530",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264216",
            "telephone_number": "414-443-0033",
            "fax_number": "414-443-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMBNY",
        "first_name": "KENNETH",
        "middle_name": "DELL",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WI",
            "license": "35379020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33331000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.