Kenneth Eric Antonoff in Kenosha - Dentist
Kenneth Eric Antonoff - NPI 1205842721
Kenneth Eric Antonoff is a Dentist in Kenosha, Wisconsin. Kenneth Eric Antonoff practices all healthcare services and medical treatments related to Dentist. The NPI Number for Kenneth Eric Antonoff is 1205842721. The last update date is 2022-06-16.
Kenneth Eric Antonoff's current location address is 6803 Sheridan Rd, Kenosha, Wisconsin. You can contact this provider via phone number 2624844356 and fax number 2624844367. The mailing address for Kenneth Eric Antonoff is 6803 Sheridan Rd, Kenosha, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth Eric Antonoff |
|---|---|
| Address | 6803 Sheridan Rd, Kenosha, Wisconsin |
| Phone Number | 2624844356 |
| Fax Number | 2624844367 |
| Sole Proprietor | Y |
| Credentials | D.D.S |
NPI Number Detail
| NPI Number | 1205842721 |
|---|---|
| Provider Enumeration Date | 2006-08-01 |
| Last Updated Date | 2022-06-16 |
Provider Mailing Address Detail
| Address | 6803 Sheridan Rd |
|---|---|
| City | Kenosha |
| State | Wisconsin (WI) |
| Post Code | 531431321 |
| Phone Number | 2624844356 |
| Fax Number | 2624844367 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 6823-15 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 319014674 | IL | TAX ID |
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What is the unique 10-digit identification code issued to Kenneth Eric Antonoff by the Centers for Medicare & Medicaid Services?
The Kenneth Eric Antonoff has been assigned the NPI (National Provider Identifier) 1205842721 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete address where Kenneth Eric Antonoff is physically located?
The Kenneth Eric Antonoff is situated at the following address: 6803 Sheridan Rd, Kenosha, WI 531431321.
What is the Kenneth Eric Antonoff's specialty and taxonomy code?
The Kenneth Eric Antonoff's specialty is Dentist, and the corresponding taxonomy code is 122300000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1205842721 to Kenneth Eric Antonoff?
The Centers for Medicare & Medicaid Services originally issued the 1205842721 to Kenneth Eric Antonoff on 2006-08-01.
When was the information pertaining to Kenneth Eric Antonoff most recently updated or revised?
The details related to Kenneth Eric Antonoff, including its address, specialty, and other relevant information, were last updated or revised on 2022-06-16.
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