Individual provider Active NPI

Emily Driesenga, EFDA

  • Dental Assistant
  • Oconto, WI
National Provider Identifier
1710890900
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
50149-116 Issued in WI
Practice address
155 Memorial Dr
Oconto, WI 54153-2053
Phone
(920) 516-7107
Fax
(920) 516-1940
NPI assigned
Sep 28, 2026
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X 50149-116 WI Primary

Addresses

Primary practice location

155 Memorial Dr
Oconto, WI 54153-2053

Mailing address

155 Memorial Dr
Oconto, WI 54153-2053
Phone (920) 516-7107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1710890900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 MEMORIAL DR",
            "city": "OCONTO",
            "state": "WI",
            "postal_code": "541532053",
            "telephone_number": "920-516-7107",
            "fax_number": "920-516-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MEMORIAL DR",
            "city": "OCONTO",
            "state": "WI",
            "postal_code": "541532053",
            "telephone_number": "920-516-7107",
            "fax_number": "920-516-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRIESENGA",
        "first_name": "EMILY",
        "credential": "EFDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-28",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "WI",
            "license": "50149-116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconto, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.