MODERN FAMILY DENTISTS LLC (NPI# 1639574585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639574585 |
| Entity Type | Organization |
| Organization Name | MODERN FAMILY DENTISTS LLC |
| Practice Address |
6803 Sheridan Rd Kenosha WI 53143-1321 |
| Practice Telephone | 2624844356 |
| Mailing Telephone | 2624844356 |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2014-11-04 |
| Authorized Official Name | MRS. JAMIE MORSEHEAD (PATIENT EXPERIENCE COORDINATOR) |
| Authorized Official Telephone | 2624844356 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
6803 SHERIDAN RD |
| City | KENOSHA |
| State | WI |
| Zip Code | 53143-1321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467551887 | Michaelangelo D Aust | Dentist | 6803 Sheridan Rd, Kenosha, WI 53143-1321 | 2006-09-22 |
| 1588863328 | Natalija Aust | Dentist | 6803 Sheridan Rd, Kenosha, WI 53143-1321 | 2007-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891262275 | Shanda L Goecks | Registered Nurse | 6916 26th Ave, Kenosha, WI 53143 | 2018-10-24 |
| 1689942989 | Racine Kenosha Community Action Agency | Public Health or Welfare | 2000 63rd Street, Kenosha, WI 53143 | 2011-12-01 |
| 1538497797 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7525 Sheridan Rd, Kenosha, WI 53143 | 2009-11-30 |
| 1497929012 | Ebba M Johnson | Physical Therapist | 524 74th Street, Kenosha, WI 53143 | 2008-04-15 |
| 1770789489 | Kenosha Community Health Center, Inc | Family Medicine | 6226 14th Ave, Kenosha, WI 53143 | 2007-06-21 |
| 1558413161 | Junith M Thompson | Obstetrics & Gynecology | 6530 Sheridan Road, Kenosha, WI 53143 | 2007-01-17 |
| 1154471332 | Ljh Ambulance, Inc | Ambulance | 6329 28th Ave, Kenosha, WI 53143 | 2007-01-11 |
| 1578625794 | Michael A Schellpfeffer Md Ob Gyn Sc | Obstetrics & Gynecology | 1400 75th Street, Kenosha, WI 53143 | 2006-12-14 |
| 1457468654 | Yasmine S Sido | Physician Assistant | 7550 22nd Ave, Kenosha, WI 53143 | 2006-08-24 |
| 1356307359 | Nancy Jane Houtchens | Dentist | 7533 22nd Ave, Ste 100, Kenosha, WI 53143 | 2006-04-26 |
| Find all providers in zip 53143 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205364197 | Kenosha Dentist LLC | Dentist | 5455 Sheridan Rd Ste 201, Kenosha, WI 53140-3752 | 2017-05-23 |
| 1154782209 | Familia Dental Kenosha LLC | Dentist | 6430 Green Bay Rd, Ste 112, Kenosha, WI 53142-2948 | 2016-03-17 |
| 1831365907 | Martha C. Villasenor | Dentist | 7177 W. Green Bay Rd., 7177 W. Green Bay Rd., Kenosha, WI 53142-1450 | 2008-05-07 |
| 1649464090 | Vincent C Rizzo | Dentist | 7536 39th Avenue, Kenosha, WI 53142 | 2007-08-29 |
| 1972793099 | Robert C. Salituro | Dentist | 3515 75th St, Kenosha, WI 53142-7224 | 2007-07-25 |
| 1821292806 | Robert Stephen Willding | Dentist | 7003 39th Avenue, Kenosha, WI 53142-7132 | 2007-06-13 |
| 1578782520 | Todd Armstrong | Dentist | 7910 39th Ave, Kenosha, WI 53142-2132 | 2007-04-25 |
| 1316063530 | Michael Anthony Walsh | Dentist | 2600 22nd Ave, Kenosha, WI 53140-4813 | 2007-03-21 |
| 1497889216 | Luigi A Caira | Dentist | 4320 60th St, Kenosha, WI 53144-2577 | 2007-03-15 |
| 1740314293 | Charles Marquiss Ashley | Dentist | 7505 38th Ave, Kenosha, WI 53142-4341 | 2007-03-15 |
| Find all providers in KENOSHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.