Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kenosha Dentist LLC

Organization General Practice Dentistry · NPI 1205364197

Kenosha Dentist LLC is a General Practice Dentistry in Kenosha, Wisconsin. Registered with an NPI since 2017.

In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5455 Sheridan Rd Ste 201
Kenosha, WI 53140-3752
Phone: (262) 244-0700
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1205364197
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dominic Kaczynski — Business Manager · (262) 244-0700
NPI enumeratedMay 23, 2017
Last updated in NPPESMay 23, 2017
Mailing address5455 Sheridan Rd Ste 201, Kenosha, WI 53140-3752

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