Individual provider Active NPI

Catherine Eileen Zimmermann, DDS

  • Dentist
  • Burlington, WI
National Provider Identifier
1962010579
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1002374 Issued in WI
Practice address
190 Gardner Ave Ste 7
Burlington, WI 53105-2160
Phone
(262) 763-7005
NPI assigned
Jul 20, 2020
Last updated
Jul 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1002374 WI Primary

Addresses

Primary practice location

190 Gardner Ave Ste 7
Burlington, WI 53105-2160

Mailing address

190 Gardner Ave Ste 7
Burlington, WI 53105-2160
Phone (262) 763-7005

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
I20221212003071 WI Order and Referring Only - DentistPractitioner - Dentist 0648649731

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1002374WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1962010579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 GARDNER AVE STE 7",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531052160",
            "telephone_number": "262-763-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 GARDNER AVE STE 7",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531052160",
            "telephone_number": "262-763-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMANN",
        "first_name": "CATHERINE",
        "middle_name": "EILEEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-20",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1002374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WI

Sources for this page

Verify at the official NPI Registry.