Active NPI
Nidhi Mahajan, DMD
- Dentist
- Beaver Dam, WI
National Provider Identifier
1104563816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6001011-15
- Practice address
- 105 Warren St Ste 2
Beaver Dam, WI 53916-3012 - Phone
- (262) 524-9000
- NPI assigned
- May 14, 2022
- Last updated
- Oct 1, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6001011-15 | WI | Primary |
Addresses
Primary practice location
105 Warren St Ste 2
Beaver Dam, WI 53916-3012
Mailing address
105 Warren St Ste 2
Beaver Dam, WI 53916-3012
Phone (920) 887-1432
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 |
|---|---|---|---|
| 6001011-15 | WI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dentistry With Dr M LLC | Current | Accepting new patients | |
| Alison Meudt | Dentist | Past | Accepting new patients |
Locations
105 Warren St
Ste 2
Beaver Dam, WI 53916
Phone (262) 524-9000
Organizations & group practices 2
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.
-
dba Beaver Dam Family Dentistry
- Dental Clinic/Center
- Beaver Dam, WI
- NPI 1003796285
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759276800000",
"number": "1104563816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 WARREN ST STE 2",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539163012",
"telephone_number": "920-887-1432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 WARREN ST STE 2",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539163012",
"telephone_number": "262-524-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHAJAN",
"first_name": "NIDHI",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-14",
"last_updated": "2025-10-01",
"certification_date": "2025-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "6001011-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaver Dam, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.