Nina Rakowsky
Individual provider Active NPI General Practice Dentistry · West Milwaukee, WI
NPI 1962980102 · NPPES record last updated Jul 31, 2018
Key facts
- NPI
- 1962980102
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 1001905-15 (WI)
- Practice address
- 2100 Miller Park Way
West Milwaukee, WI 53219-1641 - Phone
- (414) 645-4540
- NPI assigned
- Jul 31, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180821000350 | WI | Order and Referring Only - Dentist |
1153670484 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1001905-15 | WI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rakowsky Dental LLC | Current | Accepting new patients | |
| Dental Associates LTD of Wisconsin | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1001905-15 | WI | Yes |
Addresses
Primary practice location
2100 Miller Park Way
West Milwaukee, WI 53219-1641
Mailing address
2257 Bellflower LN
New Hope, PA 18938-5501
Phone (215) 527-9447
Other providers in West Milwaukee, WI
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- Stephanie R Reeves
- Nicole Marie Reise
- Helen Robinson
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All providers in West Milwaukee, WI · General Practice Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.