Individual provider Active NPI

Tia Dorsey, RDH

  • Dental Hygienist
  • Milwaukee, WI
National Provider Identifier
1609240472
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
10912-16 Issued in WI
Practice address
1730 S 13TH St
Milwaukee, WI 53204-3201
Phone
(414) 383-3220
NPI assigned
Nov 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 10912-16 WI Primary

Addresses

Primary practice location

1730 S 13TH St
Milwaukee, WI 53204-3201

Mailing address

1210 W North Ave
Apt# 202
Milwaukee, WI 53205-1269
Phone (414) 517-5653

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

LicenseStateTypeSpecialty
10912-16WIMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
KTK Investment Services LLC Current Accepting new patients
Blended Hands LLC Current Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1609240472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 W NORTH AVE",
            "address_2": "APT# 202",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532051269",
            "telephone_number": "414-517-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 S 13TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532043201",
            "telephone_number": "414-383-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORSEY",
        "first_name": "TIA",
        "name_prefix": "Ms.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-17",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WI",
            "license": "10912-16",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; 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.