DR. KELLEY MARIE DENTINO D.M.D.
NPI 1609276120
Dentist - Orthodontics and Dentofacial Orthopedics in Menomonee Falls, WI

Active since September 03, 2014PECOS Enrolled
W178N9201 WATER TOWER PL, MENOMONEE FALLS, WI 53051(262) 251-8704 Get Directions Write a Review

NPPES record last updated: June 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kelley Marie Dentino D.m.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KELLEY MARIE DENTINO D.M.D. (NPI 1609276120) is an individual orthodontics and dentofacial orthopedics provider in Menomonee Falls, Wisconsin, licensed in Wisconsin (1001985-15) and active in the NPI registry since September 2014. She is enrolled in Medicare PECOS and maintains a secondary practice location in Boston.

NPPES Registry Identity

NPI1609276120
Entity TypeIndividualFemale
Primary Taxonomy1223X0400X
Provider Legal NameDR. KELLEY MARIE DENTINOCredential: D.M.D.
Location AddressW178N9201 WATER TOWER PLMenomonee Falls, WI 53051-8044
Mailing AddressW178n9201 Water Tower Pl Ste 100Menomonee Falls, WI 53051-8045 · (262) 251-8704
Sole ProprietorNo
Enumeration DateSeptember 3, 2014
Last NPPES UpdateJune 8, 2025
NPPES CertifiedJune 8, 2025
NPI 1609276120 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyDentist · Orthodontics and Dentofacial OrthopedicsDental Providers
Taxonomy Code1223X0400X
License Licensed in WI · 1001985-15
Definition
That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.
Also ListedDentistTaxonomy 122300000X · License DN1856732 (MA)
W178N9201 WATER TOWER PL, Menomonee Falls, WI 53051

Secondary Practice Location 1

Location 1300 Longwood Ave, Department of Plastic & Oral SurgeryBoston, MA 02115-5724 · Phone (414) 861-0912

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Kelley Marie Dentino D.m.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53051 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
W178N9201 WATER TOWER PL
MENOMONEE FALLS, WI 53051
Occupational Therapist
W178N9201 WATER TOWER PL
MENOMONEE FALLS, WI 53051
Occupational Therapist
W178N9201 WATER TOWER PL
MENOMONEE FALLS, WI 53051
Dentist
W178N9201 WATER TOWER PL
MENOMONEE FALLS, WI 53051

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelley Dentino's NPI number?

The NPI number for Kelley Dentino is 1609276120. It was assigned to this individual provider in the NPPES registry on September 3, 2014.

Where is Kelley Dentino located?

Kelley Dentino practices at W178n9201 Water Tower Pl, Menomonee Falls, WI 53051. The listed phone number is (262) 251-8704.

What is Kelley Dentino's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Orthodontics and Dentofacial Orthopedics, with taxonomy code 1223X0400X.

Is Kelley Dentino enrolled in Medicare?

Yes. Kelley Dentino is registered in the Medicare PECOS enrollment system.

What insurance does Kelley Dentino accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Delta Dental of Wisconsin, Inc. and Humana list Kelley Dentino as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelley Dentino was last updated on June 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.