Active NPI
Pamela A Thiesing
- Dental Hygienist
- Hayward, WI
National Provider Identifier
1558535047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 1001802-016
- Practice address
- 13380 W Trepania Rd
Hayward, WI 54843-2186 - Phone
- (715) 638-5100
- Fax
- (715) 634-6107
- NPI assigned
- Apr 16, 2008
- Last updated
- Apr 16, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 1001802-016 | WI | Primary |
Addresses
Primary practice location
13380 W Trepania Rd
Hayward, WI 54843-2186
Mailing address
13380 W Trepania Rd
Hayward, WI 54843-2186
Phone (715) 638-5100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1001802-016 | WI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208304000000",
"number": "1558535047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13380 W TREPANIA RD",
"city": "HAYWARD",
"state": "WI",
"postal_code": "548432186",
"telephone_number": "715-638-5100",
"fax_number": "715-634-6107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13380 W TREPANIA RD",
"city": "HAYWARD",
"state": "WI",
"postal_code": "548432186",
"telephone_number": "715-638-5100",
"fax_number": "715-634-6107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIESING",
"first_name": "PAMELA",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-16",
"last_updated": "2008-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WI",
"license": "1001802-016",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hayward, WI
- The Duluth Clinic, LTD (Essentia Health Hayward Pharmacy)
- The Lakes Community Health Center, Inc (NorthLakes Community Clinic)
- The Lakes Community Health Center, Inc
- The Lakes Community Health Center, Inc (NorthLakes Community Clinic)
- Julie Theisen
- James William Toftness, DC
- Jon T Tolliver, CSAC
- Michaela Hyunjoo Tong, M.D.
- Paul Robert Tonkin, M.D.
- Tamara Tucker, RDH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.