OrganizationActive
Kenosha Dentist LLC
NPI 1205364197 · General Practice Dentistry · Kenosha, WI
Kenosha Dentist LLC is a General Practice Dentistry organization in Kenosha, WI (NPI 1205364197).
Provider details
- NPI number
- 1205364197
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Dominic Kaczynski, Business Manager(262) 244-0700
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(70/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 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
5455 Sheridan Rd Ste 201
Kenosha, WI 53140-3752
Phone: (262) 244-0700
Street-level locationGet directions
Mailing address
5455 Sheridan Rd Ste 201
Kenosha, WI 53140-3752
Registry dates
- Enumerated
- 2017-05-23
- Last updated
- 2017-05-23
Frequently asked questions
- What is Kenosha Dentist LLC's NPI number?
- Kenosha Dentist LLC's National Provider Identifier (NPI) is 1205364197, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kenosha Dentist LLC?
- Kenosha Dentist LLC is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is Kenosha Dentist LLC located?
- Kenosha Dentist LLC's practice location on file with NPPES is 5455 Sheridan Rd Ste 201, Kenosha, WI 53140-3752.
- What is Kenosha Dentist LLC's phone number?
- The practice phone number listed in the NPPES registry for Kenosha Dentist LLC is (262) 244-0700.
- Who is the authorized official for Kenosha Dentist LLC?
- The authorized official listed on Kenosha Dentist LLC's NPPES record is Dominic Kaczynski, Business Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kenosha Dentist LLC's NPI active?
- Yes — Kenosha Dentist LLC's NPI (1205364197) is active in the NPPES registry as of the last update on 2017-05-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.