Kristina Marie Bath, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

7261-15 Issued in WI

Practice address

105 W Silver Spring Dr
Whitefish Bay, WI 53217-4708

Phone

(414) 964-0680

NPI assigned

Jun 17, 2014

Last updated

Jun 17, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Edp of Wisconsin, SC

  • Dental Clinic/Center
  • Hartland, WI
  • NPI 1639685779
  NPD (past)

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1093129165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W SILVER SPRING DR",
            "city": "WHITEFISH BAY",
            "state": "WI",
            "postal_code": "532174708",
            "telephone_number": "414-964-0680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W SILVER SPRING DR",
            "city": "WHITEFISH BAY",
            "state": "WI",
            "postal_code": "532174708",
            "telephone_number": "414-964-0680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATH",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "7261-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Mary App, RN
• Athletic and Therapeutic Institute of Milwaukee, LLC (ATI Physical Therapy)
• Aurora Advanced Healthcare Inc
• Yasleny F Baker, APNP
• Douglas Robert Barden, DDS, MS
• Mary Catherine Becker-Roth, RN
• Lauryn Marie Beecher, DPT
• Kaitlin Bell, PA
• Bridget G Brinckman, PHD
• Brothers Transpo

• Dentist in Whitefish Bay, WI
• Providers in Whitefish Bay, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.