NPIMap

Organization Active NPI

Applewhite Dental Wisconsin, P.C.

Doing business as Northside Kenosha Dental

  • General Practice Dentistry
  • Kenosha, WI
National Provider Identifier
1861046047
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
APPLEWHITE DENTAL WISCONSIN, P.C.
Doing business as
Northside Kenosha Dental
Practice address
2600 22ND Ave
Kenosha, WI 53140-4813
Phone
(262) 658-1410
NPI assigned
Jul 26, 2019
Last updated
Jul 29, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
APPLEWHITE DENTAL PARTNERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Authorized official

Name
Sharon L Loso
Title
Credentialing Specialist
Phone
(563) 582-1448

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

2600 22ND Ave
Kenosha, WI 53140-4813

Mailing address

40 Main St Ste 100
Dubuque, IA 52001-7654
Phone (563) 582-1448

Other names 1

  • Northside Kenosha Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Applewhite Dental Wisconsin PC9 organizations share this tax ID, including this one
Part of
Applewhite Dental Wisconsin PC

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2600 22nd Ave
Kenosha, WI 53140
Phone (262) 658-1410

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564358400000",
    "number": "1861046047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MAIN ST STE 100",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520017654",
            "telephone_number": "563-582-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 22ND AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404813",
            "telephone_number": "262-658-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLEWHITE DENTAL WISCONSIN, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "APPLEWHITE DENTAL PARTNERS",
        "enumeration_date": "2019-07-26",
        "last_updated": "2019-07-29",
        "status": "A",
        "authorized_official_last_name": "LOSO",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "563-582-1448"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northside Kenosha Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northside Kenosha Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 29, 2019; 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.