Lucy Wanda Komorowski, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

6002099-15 Issued in WI

Practice address

1245 Main St
Green Bay, WI 54302-1306

Phone

(920) 965-0831

NPI assigned

Jul 16, 2012

Sex

Female

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1952656043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 MAIN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543021306",
            "telephone_number": "920-965-0831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 MAIN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543021306",
            "telephone_number": "920-965-0831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMOROWSKI",
        "first_name": "LUCY",
        "middle_name": "WANDA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6002099-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicolette Taylor Kollath, DDS
• Paul A Kollath, DDS
• Molly C Kollross, PT
• Matthew Kolonich, CRNA
• Kayla Kolstad
• Jack Komro, DO
• Tseun Han James Kong, M.B.B.CH, B.A.O.
• Margaret Jane Konopasek, PA-C
• Adam Koopmann
• Kailey Koponen

• Dentist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.