Gisela Gunderson
Individual provider Active NPI Dental Hygienist · Lakewood, WI
NPI 1174828024 · NPPES record last updated Jan 24, 2011
Key facts
- NPI
- 1174828024
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 6070 (WI)
- Practice address
- 15397 State Highway 32
Lakewood, WI 54138-9702 - Phone
- (715) 276-6321
- Fax
- (262) 654-9333
- NPI assigned
- Jan 24, 2011
- 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 |
|---|---|---|---|
| 6070 | WI | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 6070 | WI | Yes |
Addresses
Primary practice location
15397 State Highway 32
Lakewood, WI 54138-9702
Mailing address
15397 State Highway 32
Lakewood, WI 54138-9702
Phone (715) 276-6321
Other providers in Lakewood, WI
- Blake J Edinger
- Rene A Farah
- Christi Fowler
- Leslee A Granke
- Ashlei Elaine Guarisco
- Habeck Chiropractic Center, LLC
- Adam Robert Habeck
- Jennifer Halverson
- Jill Heath-Karpinen
- Ted A Jung
All providers in Lakewood, WI · Dental Hygienist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2011. 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.