Individual provider Active NPI

Kimberly Newman Schmittou, D.D.S.

  • General Practice Dentistry
  • Janesville, WI
National Provider Identifier
1265798854
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7121-15 Issued in WI
Practice address
107 N Crosby Ave
Janesville, WI 53548-3333
Phone
(608) 752-7931
NPI assigned
Apr 9, 2012
Last updated
Oct 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7121-15 WI Primary

Addresses

Primary practice location

107 N Crosby Ave
Janesville, WI 53548-3333

Mailing address

107 N Crosby Ave
Janesville, WI 53548-3333
Phone (608) 752-7931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161109001859 WI Order and Referring Only - DentistPractitioner - Dentist 9537468335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7121-15WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Haye Dental Group General Practice 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1265798854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N CROSBY AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535483333",
            "telephone_number": "608-752-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N CROSBY AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535483333",
            "telephone_number": "608-752-7931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMITTOU",
        "first_name": "KIMBERLY",
        "middle_name": "NEWMAN",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-09",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "7121-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

Verify at the official NPI Registry.