Active NPI
Angela Kussow, RDH
- Dental Hygienist
- Dodgeville, WI
National Provider Identifier
1790102143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 5616-16
- Practice address
- 103 E. Fountain St.
Dodgeville, WI 53533-1749 - Phone
- (608) 935-5550
- Fax
- (608) 935-5168
- NPI assigned
- Mar 24, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 5616-16 | WI | Primary |
Addresses
Primary practice location
103 E. Fountain St.
Dodgeville, WI 53533-1749
Mailing address
2901 W Beltline Hwy
Suite 120
Madison, WI 53713-4226
Phone (608) 443-5500
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 |
|---|---|---|---|
| 5616-16 | WI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397692800000",
"number": "1790102143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 W BELTLINE HWY",
"address_2": "SUITE 120",
"city": "MADISON",
"state": "WI",
"postal_code": "537134226",
"telephone_number": "608-443-5500",
"fax_number": "608-441-2385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 E. FOUNTAIN ST.",
"city": "DODGEVILLE",
"state": "WI",
"postal_code": "535331749",
"telephone_number": "608-935-5550",
"fax_number": "608-935-5168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUSSOW",
"first_name": "ANGELA",
"name_prefix": "Mrs.",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-24",
"last_updated": "2014-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WI",
"license": "5616-16",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dodgeville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.