Active NPI
Amanda Marie Duckworth, RDH
- Dental Hygienist
- Elkhorn, WI
National Provider Identifier
1982332706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 6818-016
- Practice address
- 209 E Commerce CT
Elkhorn, WI 53121-4371 - Phone
- (262) 379-1401
- NPI assigned
- Aug 10, 2022
- Last updated
- Aug 10, 2022
- Sex
- Female
- Sole proprietor
- No
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 | 6818-016 | WI | Primary |
Addresses
Primary practice location
209 E Commerce CT
Elkhorn, WI 53121-4371
Mailing address
N2445 Crispus Attucks Dr
Burlington, WI 53105-3547
Phone (414) 405-2940
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 |
|---|---|---|---|
| 6818-016 | WI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660089600000",
"number": "1982332706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N2445 CRISPUS ATTUCKS DR",
"city": "BURLINGTON",
"state": "WI",
"postal_code": "531053547",
"telephone_number": "414-405-2940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 E COMMERCE CT",
"city": "ELKHORN",
"state": "WI",
"postal_code": "531214371",
"telephone_number": "262-379-1401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUCKWORTH",
"first_name": "AMANDA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-10",
"last_updated": "2022-08-10",
"certification_date": "2022-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WI",
"license": "6818-016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkhorn, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.