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

Racine Periodontics and Implant Dentistry Ltd

Organization Periodontics · NPI 1215634266

Racine Periodontics and Implant Dentistry Ltd is a Periodontics in Lake Geneva, Wisconsin. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

255 Havenwood Dr
Lake Geneva, WI 53147-1988
Phone: (262) 248-8505
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X

Record details

NPI number1215634266
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Adrian Rivas — Owner · (305) 807-9082
NPI enumeratedFebruary 9, 2023
Last updated in NPPESFebruary 9, 2023
Certification dateFebruary 9, 2023
Mailing address4715 James Ave, Racine, WI 53402-2642

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