NPIMap

Organization Active NPI

Racine Dental Center LLC

  • Dentist
  • Racine, WI
National Provider Identifier
1932814670
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
RACINE DENTAL CENTER LLC
Practice address
1101 S Airline Rd
Racine, WI 53406-3888
Phone
(262) 637-9371
NPI assigned
Jan 17, 2023
Last updated
Jul 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Authorized official

Name
Victoria Johnson
Title
Cro
Phone
(941) 444-0558

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

1101 S Airline Rd
Racine, WI 53406-3888

Mailing address

1101 S Airline Rd
Racine, WI 53406-3888

Other practice location 1

851 Park Dr Ste 103
Lake Geneva, WI 53147-4586
Phone (262) 248-1601

Other names 1

  • Dental Care Alliance Other name

National Provider Directory

National Provider Directory

Locations

851 Park Dr
Ste 103
Lake Geneva, WI 53147
Phone (262) 248-1601

1101 S Airline Rd
Mount Pleasant, WI 53406
Phone (262) 333-3744

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784505600000",
    "number": "1932814670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 S AIRLINE RD",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534063888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 S AIRLINE RD",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534063888",
            "telephone_number": "262-637-9371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "851 Park Dr Ste 103",
            "address_purpose": "LOCATION",
            "city": "Lake Geneva",
            "state": "WI",
            "postal_code": "531474586",
            "country_code": "US",
            "telephone_number": "262-248-1601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RACINE DENTAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-17",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "CRO",
        "authorized_official_telephone_number": "941-444-0558"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care Alliance",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Dental Care Alliance",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 20, 2026; 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.