MRS. BETHANY LYN GALLISTEL (NPI# 1326678749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326678749 |
| Entity Type | Individual |
| Full Name | MRS. BETHANY LYN GALLISTEL |
| Other Name | MISS BETHANY LYN DICK |
| Credential | RDH |
| Practice Address |
2524 E Webster Pl Ste 201 Milwaukee WI 53211-4257 |
| Mailing Address |
2954 N Fratney St Milwaukee WI 53212-2626 |
| Practice Telephone | 4149639440 |
| Mailing Telephone | 4146888732 |
| Enumeration Date | 2020-01-24 |
| Last Update Date | 2020-01-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 10319-16 | WI | Dental Providers |
| Street Address |
2524 E WEBSTER PL STE 201 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53211-4257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174751523 | Megan Graham | Dentist | 2524 E Webster Pl Ste 201, Milwaukee, WI 53211-4257 | 2009-06-24 |
| 1184279028 | Lake Park Dental LLC | Clinic/Center | 2524 E Webster Pl Ste 201, Milwaukee, WI 53211-4257 | 2019-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821602335 | Gabriella Caitrin Emanuele | Occupational Therapist | Harborchase of Shorewood, 1111 E Capitol Drive, Shorewood, WI 53211 | 2020-09-02 |
| 1710527783 | Sage Specialty Pharmacy Inc. | Pharmacy | 4001 N. Oakland Ave, Shorewood, WI 53211 | 2020-01-08 |
| 1861043952 | Rosina Bloomingdale Norton | Nurse Practitioner | 1921 E Harford Ave, Milwaukee, WI 53211 | 2019-09-20 |
| 1528556255 | Renee Reckelberg | Specialist/Technologist | 3409 North Downer Avenue, Pavilion, Suite 350, Milwaukee, WI 53211 | 2018-04-27 |
| 1700325602 | Wisconsin Vision, Inc. | Optometrist | 4163 N Oakland Ave, Shorewood, WI 53211 | 2017-02-13 |
| 1750827556 | Daniel Butz M.d., S.c. | Plastic Surgery | 2350 N Lake Dr Ste 304, Milwaukee, WI 53211 | 2017-01-17 |
| 1528517232 | Therese Simonis | Speech-Language Pathologist | 2390 N Lake Drive, Milwaukee, WI 53211 | 2016-09-23 |
| 1982075701 | Katie Michel | Specialist/Technologist | 3409 N. Downer Ave, Milwaukee, WI 53211 | 2015-10-20 |
| 1255776365 | Sarah Elizabeth Brill | Social Worker | 4433 N Oakland Ave Ste D, Shorewood, WI 53211 | 2013-05-02 |
| 1679814537 | Nicole Anne Parulski | Physical Therapist | 2301 North Lake Dr, Milwaukee, WI 53211 | 2013-03-01 |
| Find all providers in zip 53211 | ||||
| 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 |
|---|---|---|---|---|
| 1760850614 | Michelle Boettcher | Dental Hygienist | 2552 S Brisbane Ave, Milwaukee, WI 53207-1502 | 2015-09-09 |
| 1093110058 | Florina Pinskaya | Dental Hygienist | 4302 N 76th St, Milwaukee, WI 53222-2004 | 2014-11-01 |
| 1699192948 | Elizabeth S Dietzler | Dental Hygienist | 4619 W Blue Mound Ct, Milwaukee, WI 53208-3607 | 2014-03-25 |
| 1508188764 | Oleesa Shapowal | Dental Hygienist | 1730 S 13th St, Milwaukee, WI 53204-3201 | 2010-02-15 |
| 1033360763 | Kory Pilkington | Dental Hygienist | 1308 S. Cesar Chavez Drive, Milwaukee, WI 53204-0408 | 2008-09-30 |
| 1477725786 | Gina L Tolson | Dental Hygienist | 2669 N 92nd St, Milwaukee, WI 53226-1800 | 2008-03-26 |
| 1215020128 | Sharon Wildes | Dental Hygienist | Milwaukee Vamc Dental Clinic, 5000 National Ave, Milwaukee, WI 53295-0001 | 2006-10-02 |
| 1255360632 | Carol Lynn Bright | Dental Hygienist | 1135 South Cesar Chavez Drive, Milwaukee, WI 53204 | 2006-06-30 |
| 1790781185 | Michele Straetz | Dental Hygienist | 2306 S Kinnickinnic Ave, Milwaukee, WI 53207-1626 | 2005-06-22 |
| 1336748516 | Amber M Randle | Dental Hygienist | 1730 S 13th St, Milwaukee, WI 53204-3201 | 2020-10-20 |
| Find all providers in MILWAUKEE | ||||
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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.