AWDM, LLC (NPI# 1629220983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629220983 |
| Entity Type | Organization |
| Organization Name | AWDM, LLC |
| Practice Address |
4113 Rib Mountain Drive Wausau WI 54401 |
| Mailing Address |
Po Box 3189 Syracuse NY 13220-3189 |
| Practice Telephone | 7153596060 |
| Mailing Telephone | 3154546000 |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2008-10-17 |
| Authorized Official Name | ROBERT FONTANA (PRESIDENT) |
| Authorized Official Telephone | 3154546000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
4113 RIB MOUNTAIN DRIVE |
| City | WAUSAU |
| State | WI |
| Zip Code | 54401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265680714 | Anthony George Montagna | Dentist | 4113 Rib Mountain Drive, Wausau, WI 54401 | 2008-09-08 |
| 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 | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205451598 | Tysen Wood | Dentist | 605 S 24th Ave Ste 10, Wausau, WI 54401-1705 | 2020-06-11 |
| 1558873406 | Dental Options, LLC | Dentist | 2600 Stewart Ave Ste 158, Wausau, WI 54401-1404 | 2017-11-01 |
| 1073876678 | Tessa Marie Laber | Dentist | 1810 N. 2nd Street, Wausau, WI 54403-3492 | 2012-06-19 |
| 1194009142 | Sirisha Gogineni | Dentist | 4113 Rib Mountain Dr, Wausau, WI 54401-0647 | 2011-10-07 |
| 1871813329 | Aaron John Bushong | Dentist | 200 E Bridge St, Suite 100, Wausau, WI 54403-3574 | 2010-06-07 |
| 1982836813 | Eric J Gabrielsen | Dentist | 200 E. Bridge St., Ste-100, Wausau, WI 54403 | 2009-08-11 |
| 1265680714 | Anthony George Montagna | Dentist | 4113 Rib Mountain Drive, Wausau, WI 54401 | 2008-09-08 |
| 1487776126 | Lenette Ellice Hoover | Dentist | 115 Forest St, Wausau, WI 54403-5504 | 2007-04-04 |
| 1215054747 | Leon Oselka | Dentist | 211 N 3rd Ave, Wausau, WI 54401-4485 | 2007-03-22 |
| 1154450567 | Jennifer Ann Havel | Dentist | 1101 N 6th St, Wausau, WI 54403-3505 | 2007-03-02 |
| 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.