JASON T WATKA (NPI# 1669617833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669617833 |
| Entity Type | Individual |
| Full Name | JASON T WATKA |
| Practice Address |
6226 14th Ave Kenosha WI 53143-4413 |
| Practice Telephone | 2629251675 |
| Mailing Telephone | 2629251675 |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2008-12-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 6921-016 | WI | Dental Providers |
| Street Address |
6226 14TH AVE |
| City | KENOSHA |
| State | WI |
| Zip Code | 53143-4413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770789489 | Kenosha Community Health Center, Inc | Family Medicine | 6226 14th Ave, Kenosha, WI 53143 | 2007-06-21 |
| 1609424837 | Heather Nicole Matejka | Dentist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2019-08-30 |
| 1801454269 | Connie Lee Bevry | Dental Hygienist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2019-05-31 |
| 1841773793 | Donna M Zagame | Dental Hygienist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2018-09-06 |
| 1033649850 | Melissa Lynn Davis | Dentist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2017-06-14 |
| 1043657158 | Tarah Marie Gerner | Dentist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2013-05-30 |
| 1467715474 | Craig A. Peterson | Dentist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2012-06-25 |
| 1457620031 | Mark Rehorst | Dentist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2011-12-28 |
| 1962788596 | Robyn L. Bednarek | Dental Hygienist | 6226 14th Ave, Suite 700, Kenosha, WI 53143-4413 | 2011-10-27 |
| 1235415993 | Delores Chovan | Dental Hygienist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2011-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891262275 | Shanda L Goecks | Registered Nurse | 6916 26th Ave, Kenosha, WI 53143 | 2018-10-24 |
| 1689942989 | Racine Kenosha Community Action Agency | Public Health or Welfare | 2000 63rd Street, Kenosha, WI 53143 | 2011-12-01 |
| 1538497797 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7525 Sheridan Rd, Kenosha, WI 53143 | 2009-11-30 |
| 1497929012 | Ebba M Johnson | Physical Therapist | 524 74th Street, Kenosha, WI 53143 | 2008-04-15 |
| 1558413161 | Junith M Thompson | Obstetrics & Gynecology | 6530 Sheridan Road, Kenosha, WI 53143 | 2007-01-17 |
| 1154471332 | Ljh Ambulance, Inc | Ambulance | 6329 28th Ave, Kenosha, WI 53143 | 2007-01-11 |
| 1578625794 | Michael A Schellpfeffer Md Ob Gyn Sc | Obstetrics & Gynecology | 1400 75th Street, Kenosha, WI 53143 | 2006-12-14 |
| 1457468654 | Yasmine S Sido | Physician Assistant | 7550 22nd Ave, Kenosha, WI 53143 | 2006-08-24 |
| 1356307359 | Nancy Jane Houtchens | Dentist | 7533 22nd Ave, Ste 100, Kenosha, WI 53143 | 2006-04-26 |
| 1871566257 | Terry W Huff Dds Sc | Clinic/Center | 6402 Sheridan Rd, Kenosha, WI 53143 | 2006-02-08 |
| Find all providers in zip 53143 | ||||
| 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 |
|---|---|---|---|---|
| 1801229570 | Angela K Fitzpatrick | Dental Hygienist | 6831 53rd St Unit 146, Kenosha, WI 53144-3770 | 2013-08-16 |
| 1730421850 | Michelle Fox, R.d.h.,s.c. | Dental Hygienist | 9220 66th St, Kenosha, WI 53142-8234 | 2013-03-27 |
| 1659613115 | Brandi Berland R.d.h., Ltd | Dental Hygienist | 11216 61st St, Kenosha, WI 53142-7261 | 2013-03-22 |
| 1487939948 | Teresa Wojtak | Dental Hygienist | 625 57th St, Suite 700, Kenosha, WI 53140-4146 | 2011-10-17 |
| 1760799076 | Michelle Lee Fox | Dental Hygienist | 9220 66th Street, Kenosha, WI 53142-8234 | 2010-09-08 |
| 1679889000 | Angela M Lupi | Dental Hygienist | 1016 83rd St, Kenosha, WI 53143-6149 | 2010-08-23 |
| 1801454269 | Connie Lee Bevry | Dental Hygienist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2019-05-31 |
| 1841773793 | Donna M Zagame | Dental Hygienist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2018-09-06 |
| 1841623451 | Angela K Fitzpatrick Rdh LLC | Dental Hygienist | 6831 53rd St Unit 146, Kenosha, WI 53144-3770 | 2013-08-19 |
| 1962788596 | Robyn L. Bednarek | Dental Hygienist | 6226 14th Ave, Suite 700, Kenosha, WI 53143-4413 | 2011-10-27 |
| Find all providers in KENOSHA | ||||
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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.