DR. STEPHANIE NICOLE WAGONER KIMBALL (NPI# 1215160148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215160148 |
| Entity Type | Individual |
| Full Name | DR. STEPHANIE NICOLE WAGONER KIMBALL |
| Credential | D.D.S. |
| Practice Address |
621 S Park St Madison WI 53715-1827 |
| Practice Telephone | 6082513535 |
| Mailing Telephone | 6082513535 |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2009-08-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
6447-015 | WI | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770664963 | Stephanie R Kimball | Massage Therapist | 6501 196th St Sw Ste C, Lynnwood, WA 98036-5980 | 2006-10-17 |
| Street Address |
621 S PARK ST |
| City | MADISON |
| State | WI |
| Zip Code | 53715-1827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235250424 | Brian Fick | Dentist | 621 S Park St, Madison, WI 53715-1827 | 2007-04-03 |
| 1124521638 | Herbert Jun | Dentist | 621 S Park St, Madison, WI 53715-1827 | 2018-03-11 |
| 1346448503 | Robert Law | Dentist | 621 S Park St, Madison, WI 53715-1827 | 2007-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851807697 | Kristi M Batchelor | Nurse Practitioner | 20 S Park St Fl 4, Madison, WI 53715 | 2017-12-15 |
| 1578927026 | Petra A Kelsey | Family Medicine | 1107 Emerald St, Madison, WI 53715 | 2016-04-11 |
| 1467889238 | Group Health Cooperative of South Central Wi | Durable Medical Equipment & Medical Supplies | 740 Regent Street, Suite 106, Madison, WI 53715 | 2013-10-10 |
| 1275888760 | Sandra Beth Miller | Physician Assistant | 700 S. Park, Suite A 404, Madison, WI 53715 | 2012-07-20 |
| 1134418486 | Matthew Lochen | Emergency Medicine | 700 S. Park Street, Department of Emergency Medicine, Madison, WI 53715 | 2011-04-06 |
| 1225275720 | Eileen J Breitweiser | Social Worker | 202 South Parkt Street, Madison, WI 53715 | 2009-01-21 |
| 1225293137 | Kenneth H. Yuska, Md, Sc | Orthopaedic Surgery | 4726 East Towne Blvd., 110, Madison, WI 53715 | 2008-07-21 |
| 1063689727 | Rachel I Kornik | Dermatology | Uw Health Dept of Dermatology 1 S. Park St, Administrative Office 7th Floor, Madison, WI 53715 | 2008-05-13 |
| 1144434911 | Rebecca Sue Frye | Pharmacist | 1 South Park Street, Suite 101 Pharmacy, Madison, WI 53715 | 2007-05-10 |
| 1376755496 | Eileen C. Scrivner | Social Worker | 1008 Fish Hatchery Road, Madison, WI 53715 | 2007-05-03 |
| Find all providers in zip 53715 | ||||
| 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 |
|---|---|---|---|---|
| 1700496007 | Elizabeth R Friend | Dentist | 440 Science Dr Ste 100, Madison, WI 53711-1064 | 2020-08-03 |
| 1841817657 | Kimberly Nicole Lee | Dentist | 105 Broadmoor Dr, Madison, MS 39110-6651 | 2020-06-26 |
| 1831713213 | Scarlett La'ree Johnson | Dentist | 155 Millhouse Dr, Madison, MS 39110-6964 | 2020-06-02 |
| 1447899653 | Say Ahh Family and Cosmetic Dentistry LLC | Dentist | 7559 Highway 72 W Ste 105a105b, Madison, AL 35758-8811 | 2020-01-06 |
| 1982245395 | Treehouse Children's Dentistry, LLC | Dentist | 7559 Highway 72 W Ste 108, Madison, AL 35758-8816 | 2019-10-07 |
| 1205480423 | Abtin Iranmanesh | Dentist | 7564 Highway 72 W Ste C, Madison, AL 35758-9437 | 2019-07-25 |
| 1396238226 | Nathalie M Gomez-leon | Dentist | 7278 Highway 72 W Ste A, Madison, AL 35758-9551 | 2018-06-14 |
| 1164915518 | Lauren Faustmann | Dentist | 20 Hughes Rd # 104, Madison, AL 35758-2237 | 2018-06-11 |
| 1669963518 | Fahad Al-fadhli | Dentist | 109 Sycamore Rdg, Madison, MS 39110-7333 | 2018-05-27 |
| 1346752441 | Pignataro Family Dentistry, PC | Dentist | 7950 Highway 72 W Ste F, Madison, AL 35758-6420 | 2017-10-30 |
| Find all providers in MADISON | ||||
Please comment or provide details below to improve the information on DR. STEPHANIE NICOLE WAGONER KIMBALL.
| 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.