Implant SpecialistFinder

Kenosha Oral Surgery, S.c.

Oral surgery practice in Kenosha, WI

Registered specialistLicense # listed (WI)

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Public-record details

Address
6707 39th Ave, Kenosha, WI 53142
Phone
(262) 658-3559
Listed under
Oral & maxillofacial surgeons, Specialty practices
NPI
1710160486
NPI status
Active in the NPPES registry
Provider type
Organization (practice, clinic or company)
Registered specialty (self-reported taxonomy)
Oral and Maxillofacial Surgery (1223S0112X)
License number on NPI record
4998015 (WI)
Authorized official
Dale Willoughby, DDS, President
NPI first issued
Dec 17, 2007
NPI record last updated
Jun 2, 2022

NPI 1710160486 is active in the federal NPPES registry (CMS) with Oral and Maxillofacial Surgery, an ADA-recognized dental specialty, as its primary taxonomy; license 4998015 (WI) is listed on the record. Source: NPPES NPI Registry (CMS) (record). Data as of 2026-09-30.

What these registry facts mean

The NPI (National Provider Identifier) is the federal ID every HIPAA-covered provider uses to bill insurance. This NPI belongs to an organization, so it may cover several clinicians at this location. The specialty is the taxonomy the provider chose when registering; NPPES does not check it. A license number here is what the provider entered — confirm it with the state board before you rely on it. Oral and maxillofacial surgeons are trained in surgery of the mouth and jaws, including placing implants, extractions, bone grafts and sinus lifts, and in anesthesia. Dentists who are not specialists can also place implants; the specialty here is the one the provider registered as primary.

View NPI 1710160486 in the official registry ↗

Checking credentials: the specialty shown is the one this provider registered with the NPI system. Your state dental board's license lookup confirms the license, and the American Board of Prosthodontics, the American Board of Oral and Maxillofacial Surgery and the American Board of Periodontology each list their board-certified members.

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