Anja Nicole Amundson, D.D.S.
Individual provider Active NPI Dentist · Appleton, WI
NPI 1245975119 · NPPES record last updated Jul 26, 2025
Key facts
- NPI
- 1245975119
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 6000044-15 (WI)
- Practice address
- 315 W Wisconsin Ave
Appleton, WI 54911-4355 - Phone
- (920) 731-2211
- NPI assigned
- May 4, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 6000044-15 | WI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tran Dental-Wi, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 6000044-15 | WI | Yes |
Addresses
Primary practice location
315 W Wisconsin Ave
Appleton, WI 54911-4355
Mailing address
837 Kelly Rd
Hudson, WI 54016-7640
Phone (715) 410-4398
Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2025. 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.