Individual provider Active NPI

Tamara Lynn Bailey, DDS

  • General Practice Dentistry
  • Schofield, WI
National Provider Identifier
1073536579
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5785-015 Issued in WI
Practice address
2809 Schofield Ave
Suite B
Schofield, WI 54476-2460
Phone
(715) 241-7980
Fax
(715) 241-7984
NPI assigned
Jul 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5785-015 WI Primary

Addresses

Primary practice location

2809 Schofield Ave
Suite B
Schofield, WI 54476-2460

Mailing address

2809 Schofield Ave
Suite B
Schofield, WI 54476-2460
Phone (715) 241-7980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150529000952 WI Order and Referring Only - DentistPractitioner - Dentist 4789904954

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5785-015WIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073536579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 SCHOFIELD AVE",
            "address_2": "SUITE B",
            "city": "SCHOFIELD",
            "state": "WI",
            "postal_code": "544762460",
            "telephone_number": "715-241-7980",
            "fax_number": "715-241-7984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 SCHOFIELD AVE",
            "address_2": "SUITE B",
            "city": "SCHOFIELD",
            "state": "WI",
            "postal_code": "544762460",
            "telephone_number": "715-241-7980",
            "fax_number": "715-241-7984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "TAMARA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5785-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schofield, WI

Sources for this page

Verify at the official NPI Registry.