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

Mitchell Shaw Kennedy

Individual provider Dentist · NPI 1124863873

Mitchell Shaw Kennedy is a Dentist in Janesville, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2024.

Licensed in
WI
In the registry since
2024

Practice location Address checks out

1336 Creston Park Dr
Janesville, WI 53545-1119
Phone: (608) 755-1082
Show map & directions

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

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 6001611-15 (WI)

Record details

NPI number1124863873
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 26, 2024
Last updated in NPPESAugust 24, 2024
Certification dateAugust 24, 2024
Mailing address1336 Creston Park Dr, Janesville, WI 53545-1119

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