Provider Demographics
NPI:1427003383
Name:RUMMELHART, JOANNE M (DDS)
Entity type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:M
Last Name:RUMMELHART
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2971 CHAPEL VALLEY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711
Mailing Address - Country:US
Mailing Address - Phone:608-661-6400
Mailing Address - Fax:608-661-6414
Practice Address - Street 1:7017 OLD SAUK RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717
Practice Address - Country:US
Practice Address - Phone:608-833-1889
Practice Address - Fax:608-662-7414
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3628122300000X
WI3628-0151223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV33765100Medicaid