Individual provider Active NPI

David Picadizo Hamm, DDS, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Madison, WI
National Provider Identifier
1053730002
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
1001201-15 Issued in WI
Practice address
4801 Cottage Grove Rd
Madison, WI 53716-1349
Phone
(608) 222-6377
NPI assigned
Apr 7, 2014
Last updated
Oct 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 1

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

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

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1001201-15WIMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1053730002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 COTTAGE GROVE RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537161349",
            "telephone_number": "608-222-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 COTTAGE GROVE RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537161349",
            "telephone_number": "608-222-6377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2408 Montana Ave",
            "address_purpose": "LOCATION",
            "city": "Sun Prairie",
            "state": "WI",
            "postal_code": "535901617",
            "country_code": "US",
            "telephone_number": "608-222-6377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Warren St Ste A",
            "address_purpose": "LOCATION",
            "city": "Beaver Dam",
            "state": "WI",
            "postal_code": "539163084",
            "country_code": "US",
            "telephone_number": "608-222-6377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMM",
        "first_name": "DAVID",
        "middle_name": "PICADIZO",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-07",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WI",
            "license": "1001201-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.