NPIMap

Individual provider Active NPI

Sylvana Blanco-Dentino, DDS

  • Dentist
  • West Allis, WI
National Provider Identifier
1992378152
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12013670A Issued in IN
Practice address
7020 W National Avenue
Suite 100
West Allis, WI 53214
Phone
(414) 475-0588
Fax
(414) 475-1166
NPI assigned
Jul 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12013670A IN Primary

Addresses

Primary practice location

7020 W National Avenue
Suite 100
West Allis, WI 53214

Mailing address

7020 W National Avenue
Suite 100
West Allis, WI 53214
Phone (414) 475-0588

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ahp 003 LLC CurrentSince Feb 2, 2025 Accepting new patients
Pro Dental in 1 PC Dentist PastSince Sep 23, 2024 Accepting new patients
D2 Dental of Hammond, P.C. Dentist PastSince Jul 1, 2021 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1992378152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7020 W NATIONAL AVENUE",
            "address_2": "SUITE 100",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "53214",
            "telephone_number": "414-475-0588",
            "fax_number": "414-475-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7020 W NATIONAL AVENUE",
            "address_2": "SUITE 100",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "53214",
            "telephone_number": "414-475-0588",
            "fax_number": "414-475-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO-DENTINO",
        "first_name": "SYLVANA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2024-10-21",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12013670A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.