Kenosha Dentist Llc is a Dental Clinic in Kenosha, Wisconsin. It is located at 5455 Sheridan Rd Ste 201, Kenosha, WI and its contact number is 262-244-0700. The authorized person for Kenosha Dentist Llc is Dominic Kaczynski
who is Business Manager of the clinic and their contact number is 262-244-0700.
Kenosha Dentist Llc Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Kenosha Dentist Llc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Kenosha Dentist Llc |
| Specialization: | General Practice Dentistry |
| Clinic Address: | 5455 Sheridan Rd Ste 201, Kenosha,
Wisconsin, 53140-3752 |
| Phone: | 262-244-0700 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Dominic Kaczynski |
| Position: | Business Manager |
| Contact Number: | 262-244-0700 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Kenosha Dentist Llc clinic are as mentioned below.
| NPI Number: | 1205364197 |
| NPI Enumeration Date: | 23 May, 2017 |
| NPI Last Update On: | 23 May, 2017 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Kenosha Dentist Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| General Practice | | | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 1699101477 | Medicaid | Illinois | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Kenosha Dentist Llc
5455 Sheridan Rd Ste 201,
Kenosha, Wisconsin |
| Zip: | 53140-3752 |
| Phone Number: | -- |
Patients can reach Kenosha Dentist Llc at
5455 Sheridan Rd Ste 201, Kenosha, Wisconsin or can
call to book an appointment on 262-244-0700.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.