Sally Mae Nazer, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6784-15 Issued in WI

Practice address

1155 W Broadway Ave
Medford, WI 54451-1372

Phone

(715) 748-4020

NPI assigned

Apr 13, 2011

Last updated

Sep 16, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Gelhaus Dental Clinic S.C.

  • Dentist
  • Medford, WI
  • NPI 1326573320
  NPD (past)

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316131200000",
    "number": "1467742262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N WASHINGTON AVE",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511424",
            "telephone_number": "715-550-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 W BROADWAY AVE",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511372",
            "telephone_number": "715-748-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZER",
        "first_name": "SALLY",
        "middle_name": "MAE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-13",
        "last_updated": "2011-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6784-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marjorie S. Miller, M.D.
• Daniel P Miskulin, DDS
• Amanda Mosse
• Karen Sue Mundt, C-SAC
• Linda Israel Murphy, LCSW
• Heidi Marie Nernberger, RDH
• Susan Lynn Netzer, RN
• Sally Rae Niziol, LPN
• David Ralph Noeldner, OTRL
• North Central Region CCS Program

• Dentist in Medford, WI
• Providers in Medford, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.