Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Racine Periodontics and Implant Dentistry Ltd

Organization Periodontics · NPI 1215634266

Racine Periodontics and Implant Dentistry Ltd provides Periodontics in Lake Geneva, Wisconsin. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

255 Havenwood Dr
Lake Geneva, WI 53147-1988
Phone: (262) 248-8505
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X

Record details

NPI number1215634266
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Adrian Rivas — Owner · (305) 807-9082
NPI enumeratedFebruary 9, 2023
Last updated in NPPESFebruary 9, 2023
Certification dateFebruary 9, 2023
Mailing address4715 James Ave, Racine, WI 53402-2642

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