Aimee M D'Amour, DDS

Individual provider Active NPI General Practice Dentistry · Waunakee, WI

NPI 1245674258 · NPPES record last updated May 16, 2016

Key facts

NPI
1245674258
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
7078-15 (WI)
Practice address
5898 Woodland Dr
Waunakee, WI 53597-8714
Phone
(608) 849-4794
NPI assigned
Apr 21, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160505001545 WI Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
4587963905

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7078-15 WI Yes

Addresses

Primary practice location

5898 Woodland Dr
Waunakee, WI 53597-8714

Mailing address

737 Reflection Dr
Verona, WI 53593
Phone (906) 282-6365

Other providers in Waunakee, WI

All providers in Waunakee, WI · General Practice Dentistry in Wisconsin

Sources for this page

Verify at the official NPI Registry.