David Picadizo Hamm, DDS, MS

Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Madison, WI

NPI 1053730002 · NPPES record last updated Oct 21, 2021

Key facts

NPI
1053730002
Entity type
Individual (NPI type 1)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
License
1001201-15 (WI)
Practice address
4801 Cottage Grove Rd
Madison, WI 53716-1349
Phone
(608) 222-6377
NPI assigned
Apr 7, 2014
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1001201-15WIMDOrthodontics and Dentofacial Orthopedic Dentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223X0400X 1001201-15 WI Yes

Addresses

Primary practice location

4801 Cottage Grove Rd
Madison, WI 53716-1349

Mailing address

4801 Cottage Grove Rd
Madison, WI 53716-1349
Phone (608) 222-6377

Other practice location 1

2408 Montana Ave
Sun Prairie, WI 53590-1617
Phone (608) 222-6377

Other practice location 2

111 Warren St Ste A
Beaver Dam, WI 53916-3084
Phone (608) 222-6377

Other providers in Madison, WI

All providers in Madison, WI · Orthodontics and Dentofacial Orthopedics Dentistry in Wisconsin

Sources for this page

Verify at the official NPI Registry.