Healthcare Provider Details

I. General information

NPI: 1619548773
Provider Name (Legal Business Name): ELLEN SAWYER KIRSCHLING DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 N MAIN ST
VERONA WI
53593-1913
US

IV. Provider business mailing address

211 WESTRIDGE PKWY
VERONA WI
53593-8332
US

V. Phone/Fax

Practice location:
  • Phone: 608-848-2000
  • Fax:
Mailing address:
  • Phone: 423-326-7797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1002651
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: