OrganizationActive
Keystone Waukesha LLC
NPI 1124868575 · Dental Clinic/Center · Waukesha, WI
Provider details
- NPI number
- 1124868575
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Tammy Kevin, Vice President(262) 873-0510
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(56/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1700 Coral Dr
Waukesha, WI 53186-1483
Phone: (262) 650-3000
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 180467
Delafield, WI 53018-0467
Registry dates
- Enumerated
- 2024-05-31
- Last updated
- 2024-05-31
- Certified
- 2024-05-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.