DEBORAH FREDERICKSON (NPI# 1366941437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366941437 |
| Entity Type | Individual |
| Full Name | DEBORAH FREDERICKSON |
| Practice Address |
1320 S Green Bay Rd Mount Pleasant WI 53406-4402 |
| Practice Telephone | 2622230280 |
| Practice Fax Number | 2622230281 |
| Mailing Telephone | 2622230280 |
| Mailing Fax Number | 2622230281 |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2018-02-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 3900 | WI | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083776942 | Deborah Lee Frederickson | Speech-Language Pathologist | 1025 N Country Club Dr, Mesa, AZ 85201-3307 | 2006-12-15 |
| Street Address |
1320 S GREEN BAY RD |
| City | MOUNT PLEASANT |
| State | WI |
| Zip Code | 53406-4402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114548633 | Roxann Nauman | Speech-Language Pathologist | 1320 S Green Bay Rd, Mount Pleasant, WI 53406-4402 | 2020-05-06 |
| 1013556547 | Jeannie Ledwitch | Dental Hygienist | 1320 S Green Bay Rd, Mount Pleasant, WI 53406-4402 | 2020-01-01 |
| 1508402520 | Megan Toms | Occupational Therapy Assistant | 1320 S Green Bay Rd, Mount Pleasant, WI 53406-4402 | 2019-11-25 |
| 1548816085 | Michelle Ann Nauman | Physical Therapist | 1320 S Green Bay Rd, Mount Pleasant, WI 53406-4402 | 2019-08-12 |
| 1578124152 | Divya Shah | Physical Therapist | 1320 S Green Bay Rd, Mount Pleasant, WI 53406-4402 | 2019-06-25 |
| 1477019750 | Sarah Marie Madigan | Occupational Therapist | 1320 S Green Bay Rd, Mount Pleasant, WI 53406-4402 | 2019-02-12 |
| 1699256206 | Brittany Lampada | Speech-Language Pathologist | 1320 S Green Bay Rd, Mount Pleasant, WI 53406-4402 | 2018-08-22 |
| 1164902052 | Alyssa Chapman | Physical Therapist | 1320 S Green Bay Rd, Mount Pleasant, WI 53406-4402 | 2018-08-20 |
| 1306330931 | Kelsey Schaefer | Specialist/Technologist | 1320 S Green Bay Rd, Mount Pleasant, WI 53406-4402 | 2018-06-18 |
| 1801389887 | Kandace Anderson | Dental Hygienist | 1320 S Green Bay Rd, Mount Pleasant, WI 53406-4402 | 2018-06-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164349 | Lynn Huynh | Pharmacist | 5695 Washington Ave, Racine, WI 53406 | 2020-11-06 |
| 1659920049 | Carol Jean Cornejo | Technician | 6528 Heritage Avenue, Mt Pleasant, WI 53406 | 2019-09-09 |
| 1265913958 | Mary Goldbeck | Social Worker | 1775 Newman Rd, Mt Pleasant, WI 53406 | 2018-08-22 |
| 1669963344 | Kelly Nicole Nelson | Registered Nurse | 8800 Washington Ave Ste 200, Mount Pleasant, WI 53406 | 2018-05-29 |
| 1891212163 | Ilona Agata Pryomski | Nurse Practitioner | 9201 Washington Ave, Racine, WI 53406 | 2017-08-27 |
| 1386185106 | Margaret M. Abaogye Dds | Dentist | 4340 Newman Rd., Racine, WI 53406 | 2017-03-13 |
| 1508309212 | Rebecca Koeppen | Dietitian, Registered | 8400 Washington Ave., Racine, WI 53406 | 2016-11-29 |
| 1386194371 | Forefront Dermatology, S.c. | Dermatology | 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 | 2016-10-13 |
| 1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
| 1861841470 | Leah Marie Johnson | Dentist | 1101 South Airline Road, Racine, WI 53406 | 2016-06-06 |
| Find all providers in zip 53406 | ||||
| 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 |
|---|---|---|---|---|
| 1124385406 | Kimberly Boudreaux | Dental Hygienist | 5559 Deerfield Rd, Mount Pleasant, WI 53406-1819 | 2012-04-11 |
| 1013556547 | Jeannie Ledwitch | Dental Hygienist | 1320 S Green Bay Rd, Mount Pleasant, WI 53406-4402 | 2020-01-01 |
| 1861963704 | Gail Joan Cyzman | Dental Hygienist | 929 Bowman Rd Ste 100, Mount Pleasant, SC 29464-3237 | 2018-12-17 |
| 1801389887 | Kandace Anderson | Dental Hygienist | 1320 S Green Bay Rd, Mount Pleasant, WI 53406-4402 | 2018-06-13 |
| 1538600135 | Karen Diane Marano | Dental Hygienist | 1320 S Green Bay Rd, Mount Pleasant, WI 53406-4402 | 2017-03-15 |
| 1508316753 | Idental | Dental Hygienist | 1320 S Green Bay Rd, Mount Pleasant, WI 53406-4402 | 2016-10-12 |
| 1669920831 | Cindi Due | Dental Hygienist | 1320 S Green Bay Rd, Mount Pleasant, WI 53406-4402 | 2016-09-16 |
| 1134575566 | Kristine Blumm | Dental Hygienist | 1320 S Green Bay Rd, Mount Pleasant, WI 53406-4406 | 2016-05-04 |
| 1386050052 | Tanya Larsen | Dental Hygienist | 6722 Green Ridge Dr, Mount Pleasant, WI 53406-5114 | 2014-07-02 |
| 1417240649 | Senior Dental Hygiene, LLC | Dental Hygienist | 3100 Tradition Cir, Mount Pleasant, SC 29466-7200 | 2011-05-20 |
| Find all providers in MOUNT PLEASANT | ||||
| City | MOUNT PLEASANT |
| Zip Code | 53406 |
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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.