Healthcare Provider Details

I. General information

NPI: 1427003383
Provider Name (Legal Business Name): JOANNE M RUMMELHART DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 01/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7017 OLD SAUK RD
MADISON WI
53717
US

IV. Provider business mailing address

2971 CHAPEL VALLEY RD SUITE 100
MADISON WI
53711
US

V. Phone/Fax

Practice location:
  • Phone: 608-833-1889
  • Fax: 608-662-7414
Mailing address:
  • Phone: 608-661-6400
  • Fax: 608-661-6414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3628
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number3628-015
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: