SHAWNA MITTELSTADT (NPI# 1447746748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447746748 |
| Entity Type | Individual |
| Full Name | SHAWNA MITTELSTADT |
| Credential | RDH |
| Practice Address |
711 W Moreland Blvd Ste 204 Waukesha WI 53188-2483 |
| Practice Telephone | 2628969891 |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2018-07-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 5094-16 | WI | Dental Providers |
| Street Address |
711 W MORELAND BLVD STE 204 |
| City | WAUKESHA |
| State | WI |
| Zip Code | 53188-2483 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992181903 | Pa Fischer | Dental Hygienist | 711 W Moreland Blvd Ste 204, Waukesha, WI 53188-2483 | 2015-08-03 |
| 1992338743 | Paulina Ramirez | Dental Hygienist | 711 W Moreland Blvd Ste 204, Waukesha, WI 53188-2483 | 2020-02-20 |
| 1720636962 | Stephanie Lynn Johnson | Dental Hygienist | 711 W Moreland Blvd Ste 204, Waukesha, WI 53188-2483 | 2019-08-30 |
| 1033767769 | Katie Ann Dvorak | Dental Hygienist | 711 W Moreland Blvd Ste 204, Waukesha, WI 53188-2483 | 2019-08-27 |
| 1417500851 | Elisa Puls | Dental Hygienist | 711 W Moreland Blvd Ste 204, Waukesha, WI 53188-2483 | 2019-07-23 |
| 1659924777 | Cathie Cissne | Dental Hygienist | 711 W Moreland Blvd Ste 204, Waukesha, WI 53188-2483 | 2019-07-17 |
| 1376020297 | Anna E Cerny | Dental Hygienist | 711 W Moreland Blvd Ste 204, Waukesha, WI 53188-2483 | 2018-07-24 |
| 1750867198 | Cassandra Jo Wendler | Dental Hygienist | 711 W Moreland Blvd Ste 204, Waukesha, WI 53188-2483 | 2018-07-18 |
| 1619464286 | Heather Kasmarek | Dental Hygienist | 711 W Moreland Blvd Ste 204, Waukesha, WI 53188-2483 | 2018-04-18 |
| 1770088460 | Carrie Kassner | Dental Hygienist | 711 W Moreland Blvd Ste 204, Waukesha, WI 53188-2483 | 2018-03-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336787126 | Nicole Lee Berg-johnson | Nurse Practitioner | 820 Crestwood Dr., Waukesha, WI 53188 | 2019-12-12 |
| 1013475706 | Rachel Mueller | Occupational Therapist | 29667 Summit Ave, S11, Waukesha, WI 53188 | 2019-03-12 |
| 1861962649 | Emily Elizabeth Seefeld | Occupational Therapy Assistant | 29667 Summit Ave S11, Waukesha, WI 53188 | 2018-12-05 |
| 1003393307 | Ashley Susan Callahan | Dental Hygienist | 711 W. Moreland Blvd., Suite 204, Waukesha, WI 53188 | 2018-07-19 |
| 1245741321 | Melissa Weir | Case Manager/Care Coordinator | 514 Riverview Avenue, Waukesha, WI 53188 | 2017-10-17 |
| 1093233629 | Patricia Marie Sombrio | Dental Hygienist | 711 Moreland Blvd 204, Waukesha, WI 53188 | 2017-09-04 |
| 1134660244 | Bdg of Wisconsin, Inc. | Behavioral Analyst | N19w2309 Riverwood Drive, Suite 350 Pmb 314, Waukesha, WI 53188 | 2017-03-09 |
| 1255888731 | Lynne Sarah Alva | Dental Hygienist | 711 Moreland Blvd, Suite 204, Waukesha, WI 53188 | 2016-09-01 |
| 1881069730 | Michelle Koch | Occupational Therapist | 29667 Summit Ave. S11, Waukesha, WI 53188 | 2015-12-03 |
| 1952711012 | Rhonda Schroeder | Dental Hygienist | W286 N991 Shepherds Way, Waukesha, WI 53188 | 2014-04-29 |
| Find all providers in zip 53188 | ||||
| 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 |
|---|---|---|---|---|
| 1003393307 | Ashley Susan Callahan | Dental Hygienist | 711 W. Moreland Blvd., Suite 204, Waukesha, WI 53188 | 2018-07-19 |
| 1093233629 | Patricia Marie Sombrio | Dental Hygienist | 711 Moreland Blvd 204, Waukesha, WI 53188 | 2017-09-04 |
| 1255888731 | Lynne Sarah Alva | Dental Hygienist | 711 Moreland Blvd, Suite 204, Waukesha, WI 53188 | 2016-09-01 |
| 1982071783 | Elizabeth Forehand | Dental Hygienist | 711 W Moreland Blvd, Suite 204, Waukesha, WI 53188-2483 | 2015-08-27 |
| 1992181903 | Pa Fischer | Dental Hygienist | 711 W Moreland Blvd Ste 204, Waukesha, WI 53188-2483 | 2015-08-03 |
| 1952711012 | Rhonda Schroeder | Dental Hygienist | W286 N991 Shepherds Way, Waukesha, WI 53188 | 2014-04-29 |
| 1336566595 | Iryna M Rudnitskaya | Dental Hygienist | 1615 Pewaukee Rd, Waukesha, WI 53188-2424 | 2014-03-26 |
| 1548525355 | Amy Elizabeth Walter | Dental Hygienist | W286n991 Shepherds Way, Waukesha, WI 53188-9493 | 2012-07-08 |
| 1477877728 | Lisa Renee Bahr | Dental Hygienist | 210 Nw Barstow St Ste 305, Waukesha, WI 53188-3771 | 2010-03-16 |
| 1992338743 | Paulina Ramirez | Dental Hygienist | 711 W Moreland Blvd Ste 204, Waukesha, WI 53188-2483 | 2020-02-20 |
| Find all providers in WAUKESHA | ||||
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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.