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Southport Periodontics

Periodontics in Kenosha, WI · enumerated 2018 · authorized official Patricia Jenkins, Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1679064901

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Registry record

Entity type Organization (Type 2)
Legal business name Southport Periodontics
Practice address 5021 Washington Rd, Kenosha, WI, 53144
Phone (262) 654-6770
Fax (262) 654-6727
Enumeration date May 22, 2018
Last updated in NPPES May 22, 2018

Taxonomy & classification

1223P0300X Periodontics Dental Providers Primary

Authorized official

Name Patricia Jenkins
Title Manager
Phone (262) 654-6770

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What type of organization is Southport Periodontics?
Southport Periodontics is registered in NPPES as a Periodontics (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2018-05-22.