Active NPI
Buhisa Abdelkafi
- Dentist
- Racine, WI
National Provider Identifier
1881383586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.034255
- Practice address
- 5201 Washington Ave Ste a
Racine, WI 53406-4242 - Phone
- (262) 634-0441
- NPI assigned
- May 8, 2023
- Last updated
- Jul 19, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.034255 | IL | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
5201 Washington Ave Ste a
Racine, WI 53406-4242
Mailing address
215 W Washington St Apt 3710
Chicago, IL 60606-3519
Phone (512) 888-7598
Other practice location 1
47 Clock Tower Plz
Elgin, IL 60120-7800
Phone (847) 695-8780
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.034255 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Familia Dental Racine LLC | Current | Accepting new patients |
Locations
5201 Washington Ave
Ste A
Mount Pleasant, WI 53406
Phone (262) 634-0441
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689724800000",
"number": "1881383586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 W WASHINGTON ST APT 3710",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606063519",
"telephone_number": "512-888-7598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5201 WASHINGTON AVE STE A",
"city": "RACINE",
"state": "WI",
"postal_code": "534064242",
"telephone_number": "262-634-0441"
}
],
"practiceLocations": [
{
"address_1": "47 Clock Tower Plz",
"address_purpose": "LOCATION",
"city": "Elgin",
"state": "IL",
"postal_code": "601207800",
"country_code": "US",
"telephone_number": "847-695-8780",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ABDELKAFI",
"first_name": "BUHISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-08",
"last_updated": "2023-07-19",
"certification_date": "2023-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.034255",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Racine, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.