MRS. AMANDA MARIE BEVERSDORF (NPI# 1184021230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184021230 |
| Entity Type | Individual |
| Full Name | MRS. AMANDA MARIE BEVERSDORF |
| Credential | RDH |
| Practice Address |
413 N 17th Ave Wausau WI 54401 |
| Practice Telephone | 7158424649 |
| Mailing Telephone | 7158424649 |
| Enumeration Date | 2014-12-04 |
| Last Update Date | 2014-12-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 10617-016 | WI | Dental Providers |
| Street Address |
413 N 17TH AVE |
| City | WAUSAU |
| State | WI |
| Zip Code | 54401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477520815 | Joshua J Spiegl | Dentist | 413 N 17th Ave, Wausau, WI 54401-4226 | 2006-03-03 |
| 1548751043 | John Robert Clifford | Dentist | 413 N 17th Ave, Wausau, WI 54401-4226 | 2018-05-21 |
| 1497030100 | Mark Dale Foster | Dentist | 413 N 17th Ave, Wausau, WI 54401-4226 | 2011-10-13 |
| 1932482841 | First Impressions, Sc Orthodontics | Clinic/Center | 413 N 17th Ave, Wausau, WI 54401-4226 | 2011-09-27 |
| 1194964783 | Tuesday Dawn Nelson | Dental Hygienist | 413 N 17th Ave, Wausau, WI 54401-4226 | 2009-02-05 |
| 1942448634 | Angela Moua | Dental Hygienist | 413 N 17th Ave, Wausau, WI 54401-4226 | 2009-02-03 |
| 1558509729 | Jessica Zelenka | Dental Hygienist | 413 N 17th Ave, Wausau, WI 54401-4226 | 2009-01-27 |
| 1255579512 | Shannon Michaela Mudler | Dental Hygienist | 413 N 17th Ave, Wausau, WI 54401-4226 | 2009-01-25 |
| 1144468653 | Laurie Johnson | Dental Hygienist | 413 N 17th Ave, Wausau, WI 54401-4226 | 2009-01-22 |
| 1235376740 | Sue Ann Stoltz | Dental Hygienist | 413 N 17th Ave, Wausau, WI 54401-4226 | 2009-01-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031464 | Central Wisconsin Endodontic Specialists LLC | Dentist | 2606 Stewart Avenue, #102, Wausau, WI 54401 | 2020-07-23 |
| 1376161976 | Family Foot and Ankle Clinic LLC | Podiatrist | 1901 Westwood Boulevard, Wausau, WI 54401 | 2020-07-09 |
| 1336701895 | Amy Kluetz | Counselor | 3000 Westhill Drive, Suite 100, Wausau, WI 54401 | 2019-07-05 |
| 1437640877 | Joseph T Fitz | Student in an Organized Health Care Education/Training Program | Aspirus Wausau Family Medicine, 425 Wind Ridge Drive, Wausau, WI 54401 | 2018-05-22 |
| 1699293241 | Amanda Nedd | Dietitian, Registered | 425 Pine Ridge Boulevard Suite 220 C, Wausau, WI 54401 | 2017-09-05 |
| 1396287447 | Dee Cha | Nurse Anesthetist, Certified Registered | 4851 Rachel Ln Apt 5, Wausau, WI 54401 | 2016-11-07 |
| 1013389618 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 2727 Plaza Dr., Wausau, WI 54401 | 2015-10-22 |
| 1881091163 | Judy Lao | Dental Hygienist | 413 North 17th Avenue, Wausau, WI 54401 | 2014-12-02 |
| 1295012011 | Allison Waraksa | Pharmacist | 504 S. 17th Ave, Wausau, WI 54401 | 2011-11-08 |
| 1881974053 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 504 S 17th Ave, Wausau, WI 54401 | 2011-08-19 |
| Find all providers in zip 54401 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801322284 | Teresa Ciejka | Dental Hygienist | 1508 Timber Ln, Wausau, WI 54403-9368 | 2017-05-04 |
| 1881091163 | Judy Lao | Dental Hygienist | 413 North 17th Avenue, Wausau, WI 54401 | 2014-12-02 |
| 1861779522 | Debra Jean Backes | Dental Hygienist | 413 N. 17th Ave., Wausau, WI 54401-2910 | 2011-11-09 |
| 1558651521 | Kori A Toepke | Dental Hygienist | 1810 N 2nd Street, Wausau, WI 54403-3492 | 2011-04-12 |
| 1518032309 | Lynette A Weiler | Dental Hygienist | 1810 North 2nd St, Wausau, WI 54403 | 2006-11-21 |
| 1720555477 | Wanda Lee Seefeldt | Dental Hygienist | 1810 North 2nd Street, Wausau, WI 54403 | 2018-10-31 |
| 1396118790 | Heather Bloecher | Dental Hygienist | 1810 N 2nd St, Wausau, WI 54403 | 2015-11-06 |
| 1447657390 | Pamela Jean Nielsen | Dental Hygienist | 413 N. 17th Ave., Wausau, WI 54401 | 2014-11-20 |
| 1033550793 | Megan Nemitz | Dental Hygienist | 1810 2nd St, Wausau, WI 54403-3492 | 2013-07-10 |
| 1376819136 | Leah I Gruhlke | Dental Hygienist | 1810 N 2nd Street, Wausau, WI 54403-3492 | 2012-03-27 |
| Find all providers in WAUSAU | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.