Active NPI
Ada Y Bazemore
- Dental Hygienist
- Milwaukee, WI
National Provider Identifier
1689089740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 10515-016
- Practice address
- 2555 N Martin Luther King Dr
Milwaukee, WI 53212-2709 - Phone
- (414) 372-8080
- Fax
- (414) 562-8432
- NPI assigned
- Jun 27, 2014
- 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 | 10515-016 | WI | Primary |
Addresses
Primary practice location
2555 N Martin Luther King Dr
Milwaukee, WI 53212-2709
Mailing address
2555 N Martin Luther King Dr
Milwaukee, WI 53212-2709
Phone (414) 372-8080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000002690 | Other | WI | MEDICARE PTAN |
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 |
|---|---|---|---|
| 10515-016 | WI | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milwaukee Health Services Inc | 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 and National Provider Directory roles.
-
- Case Management Agency
- Milwaukee, WI
- NPI 1346657442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403827200000",
"number": "1689089740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2555 N MARTIN LUTHER KING DR",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532122709",
"telephone_number": "414-372-8080",
"fax_number": "414-562-8432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2555 N MARTIN LUTHER KING DR",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532122709",
"telephone_number": "414-372-8080",
"fax_number": "414-562-8432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAZEMORE",
"first_name": "ADA",
"middle_name": "Y",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-27",
"last_updated": "2014-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WI",
"license": "10515-016",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "000002690",
"state": "WI"
}
],
"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 Jun 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.