Kimberly Bates
Individual provider Active NPI Dental Hygienist · Beloit, WI
NPI 1972076776 · NPPES record last updated Jan 4, 2019
Key facts
- NPI
- 1972076776
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 5965-16 (WI)
- Practice address
- 74 Eclipse Ctr
Beloit, WI 53511-3550 - Phone
- (608) 361-0311
- NPI assigned
- Jan 4, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5965-16 | WI | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 5965-16 | WI | Yes |
Addresses
Primary practice location
74 Eclipse Ctr
Beloit, WI 53511-3550
Mailing address
74 Eclipse Ctr
Beloit, WI 53511-3550
Phone (608) 361-0311
Other providers in Beloit, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.