Active NPI
Andrea Nicole Stanke, RDH
- Dental Hygienist
- Green Bay, WI
National Provider Identifier
1124326962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 10821-16
- Practice address
- 1711 Shawano Ave
Green Bay, WI 54303-3215 - Phone
- (920) 494-9541
- NPI assigned
- Mar 2, 2011
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 10821-16 | WI | Primary |
Addresses
Primary practice location
1711 Shawano Ave
Green Bay, WI 54303-3215
Mailing address
711 W Moreland Blvd
Waukesha, WI 53188-2483
Phone (262) 896-9891
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 |
|---|---|---|---|
| 10821-16 | WI | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Arts Associates of Green Bay LTD | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dental Clinic/Center
- Green Bay, WI
- NPI 1326173006
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729814400000",
"number": "1124326962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 W MORELAND BLVD",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531882483",
"telephone_number": "262-896-9891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1711 SHAWANO AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543033215",
"telephone_number": "920-494-9541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANKE",
"first_name": "ANDREA",
"middle_name": "NICOLE",
"name_prefix": "Miss",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-02",
"last_updated": "2024-10-25",
"certification_date": "2024-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WI",
"license": "10821-16",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.