Provider Demographics
NPI:1033360763
Name:PILKINGTON, KORY (RDH)
Entity Type:Individual
Prefix:MRS
First Name:KORY
Middle Name:
Last Name:PILKINGTON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7309 S 68TH ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-9206
Mailing Address - Country:US
Mailing Address - Phone:414-795-7126
Mailing Address - Fax:
Practice Address - Street 1:1308 S. CESAR CHAVEZ DRIVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53204-0408
Practice Address - Country:US
Practice Address - Phone:414-383-3220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6789-16124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33829400Medicaid