Tam Au, DDS
Individual provider Active NPI Dentist · Eau Claire, WI
NPI 1154053965 · NPPES record last updated Jun 29, 2022
Key facts
- NPI
- 1154053965
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 6001010-15 (WI)
- Practice address
- 3203 Stein Blvd
Eau Claire, WI 54701-6917 - Phone
- (715) 834-1060
- NPI assigned
- Jun 29, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6001010-15 | WI | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6001010-15 | WI | Yes |
Addresses
Primary practice location
3203 Stein Blvd
Eau Claire, WI 54701-6917
Mailing address
316 Colome St Apt F
Chippewa Falls, WI 54729-3817
Phone (224) 310-7469
Other providers in Eau Claire, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.