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NPI Code Detail

MEDICARE: DONNA M ZAGAME RDH

MEDICARE: DONNA M ZAGAME RDH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1124Q00000XDental Hygienist6058-16WI

General Provider Information

NPI Number : 1841773793
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNA M ZAGAME RDH
Provider Business Mailing Address
First Line : 20311 81ST ST
Second Line :
City : BRISTOL
State : WI
Zip : 53104-9711
Country : US
Telephone Number : 262-818-6510
Fax Number :
Provider Business Practice Location Address
First Line : 4006 WASHINGTON RD
Second Line :
City : KENOSHA
State : WI
Zip : 53144-4819
Country : US
Telephone Number : 262-656-0044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2018
Last Update Date : 07/17/2025

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