Individual provider Active NPI

Erin Tessendorf, DDS

  • Dentist
  • Chippewa Falls, WI
National Provider Identifier
1912263716
Registry record updated Jul 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6897-15 Issued in WI
Practice address
38 E Grand Ave
Chippewa Falls, WI 54729-2524
Phone
(715) 723-6800
NPI assigned
Apr 5, 2012
Last updated
Jul 28, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6897-15 WI Primary

Addresses

Primary practice location

38 E Grand Ave
Chippewa Falls, WI 54729-2524

Mailing address

905 Loch Wood CT
Eau Claire, WI 54703-2093
Phone (708) 921-5027

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
I20151120000236 WI Order and Referring Only - DentistPractitioner - Dentist 2163722315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Health Care Center Dentist 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, 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": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406505600000",
    "number": "1912263716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 LOCH WOOD CT",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547032093",
            "telephone_number": "708-921-5027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 E GRAND AVE",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547292524",
            "telephone_number": "715-723-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESSENDORF",
        "first_name": "ERIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-05",
        "last_updated": "2014-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6897-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chippewa Falls, WI

Sources for this page

Verify at the official NPI Registry.