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

Dr. Kali Rose Disterhoft

Individual provider Dentist · NPI 1962073577

Dr. Kali Rose Disterhoft is a Dentist in Manitowoc, Wisconsin. Licensed in Iowa and Wisconsin. Registered with an NPI since 2021.

Licensed in
IA, WI
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

33 E Waldo Blvd
Manitowoc, WI 54220-2900
Phone: (920) 682-0115
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 1002654-15 (WI)
Dentist Taxonomy 122300000X · Licence DDS-09919 (IA)

Record details

NPI number1962073577
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 6, 2021
Last updated in NPPESJuly 25, 2021
Certification dateJuly 25, 2021

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