Julie A Kastelitz, RDH

Individual provider Active NPI Dental Hygienist · Prairie Du Sac, WI

NPI 1780943282 · NPPES record last updated May 4, 2012

Key facts

NPI
1780943282
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
3244-16 (WI)
Practice address
1250 Prairie St
Prairie Du Sac, WI 53578-2041
Phone
(608) 643-8393
Fax
(608) 643-8097
NPI assigned
May 4, 2012
Sex
Female
Sole proprietor
No

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3244-16WIMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Village Family Dental Assocs. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 3244-16 WI Yes

Addresses

Primary practice location

1250 Prairie St
Prairie Du Sac, WI 53578-2041

Mailing address

1250 Prairie St
Prairie Du Sac, WI 53578-2041
Phone (608) 643-8393

Other providers in Prairie Du Sac, WI

All providers in Prairie Du Sac, WI · Dental Hygienist in Wisconsin

Sources for this page

Verify at the official NPI Registry.