Brandon Kusik, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

1001551-15 Issued in WI

Practice address

1625 W Paradise Dr
West Bend, WI 53095-7846

Phone

(262) 338-2992

NPI assigned

Jun 5, 2017

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.

• MDC West Bend, LLC

  • Dentist
  • West Bend, WI
  • NPI 1497294722
  NPD (past)
• Paradise Dental Professionals S.C.

  • Periodontics
  • West Bend, WI
  • NPI 1649492208

  Dentist

  NPD (past)
• Smile FX

  • General Practice Dentistry
  • Milwaukee, WI
  • NPI 1356096507
  NPD (past)
• Thomas J Radke DDS SC

  • General Practice Dentistry
  • Greenfield, WI
  • NPI 1053447060
  NPD (past)

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1871022822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 W PARADISE DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530957846",
            "telephone_number": "262-338-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 W PARADISE DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530957846",
            "telephone_number": "262-338-2992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5652 N Pheasant Dr",
            "address_purpose": "LOCATION",
            "city": "Nashotah",
            "state": "WI",
            "postal_code": "530589724",
            "country_code": "US",
            "telephone_number": "262-305-0262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUSIK",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-05",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001551-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Kultgen
• Rajesh Kumar, MD
• Taylor Anne Kunkel, OT
• Jacki Kunze
• Valerie Kurtz
• Jesse Kutz, PHARMD
• Joan Marie Kutz, RN
• Lisa La Susa, O.D.
• John P Lacey Jr.
• Christina M Lachner, M.S., LPC-IT

• Dentist in West Bend, WI
• Providers in West Bend, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; 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.