Individual provider Active NPI

Emily Andre, DMD, NMD, IBDM

  • General Practice Dentistry
  • Menomonie, WI
National Provider Identifier
1659682409
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6724-15 Issued in WI
Practice address
109 Oak Ave
Menomonie, WI 54751-1363
Phone
(715) 600-9004
NPI assigned
Jun 27, 2010
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 18986 FL
General Practice Dentistry 1223G0001X 6724-15 WI Primary
General Practice Dentistry 1223G0001X 13029 MN

Addresses

Primary practice location

109 Oak Ave
Menomonie, WI 54751-1363

Mailing address

109 Oak Ave
Menomonie, WI 54751
Phone (715) 600-9004

Other practice location 1

N6428 Commerce Ln
Arkansaw, WI 54721-9230
Phone (715) 230-3838

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
I20160726003303 WI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0648563783

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 18986FLMDGeneral Practice Dentistry
6724-15WIMDGeneral Practice Dentistry
13029MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gentle Dental Care SC General Practice CurrentSince Apr 25, 2021 Accepting new patients

Locations

109 Oak Ave
Menomonie, WI 54751

1813 Wilson St NE
Menomonie, WI 54751
Phone (715) 235-7566

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": "1277596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1659682409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 OAK AVE",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "54751",
            "telephone_number": "715-600-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 OAK AVE",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547511363",
            "telephone_number": "715-600-9004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N6428 Commerce Ln",
            "address_purpose": "LOCATION",
            "city": "Arkansaw",
            "state": "WI",
            "postal_code": "547219230",
            "country_code": "US",
            "telephone_number": "715-230-3838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDRE",
        "first_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "DMD, NMD, IBDM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-27",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 18986",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6724-15",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "13029",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonie, WI

Sources for this page

Verify at the official NPI Registry.