Individual provider Active NPI

Judith L Bellamy, RDH

  • Dental Hygienist
  • Milwaukee, WI
National Provider Identifier
1013558642
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
4456 Issued in WI
Practice address
5433 W Fond Du Lac Ave
Milwaukee, WI 53216-1382
Phone
(414) 445-6500
Fax
(414) 445-6618
NPI assigned
Oct 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 4456 WI Primary

Addresses

Primary practice location

5433 W Fond Du Lac Ave
Milwaukee, WI 53216-1382

Mailing address

9000 W Wisconsin Ave # Ms 958
Milwaukee, WI 53226-4874
Phone (414) 266-7615

Other identifiers 1

IdentifierTypeStateIssuer
4456-26OtherWIWISCONSIN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4456WIMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Medical Group Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1013558642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE # MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5433 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532161382",
            "telephone_number": "414-445-6500",
            "fax_number": "414-445-6618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLAMY",
        "first_name": "JUDITH",
        "middle_name": "L",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-04",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WI",
            "license": "4456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN LICENSE",
            "identifier": "4456-26",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.