Jodine Catherine Anderson, D.D.S.
Individual provider Active NPI General Practice Dentistry · Webster, WI
NPI 1053522003 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1053522003
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 5780 (WI)
- Practice address
- 4404 State Road 70
Webster, WI 54893-9251 - Phone
- (715) 349-8554
- Fax
- (715) 349-2559
- NPI assigned
- May 24, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5780 | WI | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5780 | WI | Yes |
Addresses
Primary practice location
4404 State Road 70
Webster, WI 54893-9251
Mailing address
401 Elm St
Spooner, WI 54801-1333
Phone (715) 635-9375
Other providers in Webster, WI
- Melissa Kay Allen
- Patricia Ann Anderson
- Jennifer Lynne Baldini
- Melody Lynn Bassett
- Ben Blowers, S.C.
- Benjamin McKinley DDS, LLC.
All providers in Webster, WI · General Practice Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.