Jenny Dodoy Maxwell, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

11405-16 Issued in WI

Practice address

904 Spruce St
Wausau, WI 54401-4364

Phone

(262) 510-9104

NPI assigned

Nov 20, 2021

Last updated

Oct 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1637366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1912664384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 SPRUCE ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014364",
            "telephone_number": "262-510-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 SPRUCE ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014364",
            "telephone_number": "262-510-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "JENNY",
        "middle_name": "DODOY",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-20",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WI",
            "license": "11405-16",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sally S. Mattingly, M.D.
• Wendy J Mattlin, APNP
• Nicole A Mattson, RN
• Kristina M. Mauk, LPC, SAC-IT
• Jill Walter Maxey, MS LPC
• Jocelyn D Mayer, MS BCBA LBA
• Nicole Mazzoleni
• Michael McAllister, DO
• Erinn Catherine McCabe, LPC
• Sherri McCabe, COTA

• Dental Hygienist in Wausau, WI
• Providers in Wausau, WI by specialty
• Dental Hygienist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.