Healthcare Provider Details

I. General information

NPI: 1164353660
Provider Name (Legal Business Name): ARTISAN DENTAL GPS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 N LIVINGSTON ST STE 301
MADISON WI
53703-2588
US

IV. Provider business mailing address

10 N LIVINGSTON ST STE 301
MADISON WI
53703-2588
US

V. Phone/Fax

Practice location:
  • Phone: 608-467-8022
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: NICOLE ANDERSEN
Title or Position: OWNER
Credential:
Phone: 608-467-8022