Active NPI
Sandra Jean Schroeder, DENTIAL HYGIENIST
- Dental Hygienist
- Sun Prairie, WI
National Provider Identifier
1053690552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 6706-16
- Practice address
- 6694 Sam Hill Dr
Sun Prairie, WI 53590-9384 - Phone
- (608) 825-2956
- NPI assigned
- Aug 15, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 6706-16 | WI | Primary |
| Dental Hygienist | 124Q00000X | 020.007667 | IL |
Addresses
Primary practice location
6694 Sam Hill Dr
Sun Prairie, WI 53590-9384
Mailing address
6694 Sam Hill Dr
Sun Prairie, WI 53590-9384
Phone (608) 825-2956
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
| License | State | Type | Specialty |
|---|---|---|---|
| 020.007667 | IL | MD | Dental Hygienist |
| 6706-16 | WI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477872000000",
"number": "1053690552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6694 SAM HILL DR",
"city": "SUN PRAIRIE",
"state": "WI",
"postal_code": "535909384",
"telephone_number": "608-825-2956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6694 SAM HILL DR",
"city": "SUN PRAIRIE",
"state": "WI",
"postal_code": "535909384",
"telephone_number": "608-825-2956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHROEDER",
"first_name": "SANDRA",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "DENTIAL HYGIENIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-15",
"last_updated": "2016-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WI",
"license": "6706-16",
"primary": true
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "IL",
"license": "020.007667",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sun Prairie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.