Dr. Kenneth Donald Neidhart
Periodontist
2705 Marshall Ct
Madison
, Wisconsin 53705-2255
Dr. Kenneth Donald Neidhart
Periodontist
2705 Marshall Ct
Madison
, Wisconsin 53705-2255
(608) 592-2088
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Kenneth Donald Neidhart
- 2705 Marshall Court
- Madison, WI
- Zip : 53705
- Phone : (608) 592-2088
Second Address
- Dr. Kenneth Donald Neidhart
- 2705 Marshall Ct
- Madison, WI
- Zip : 53705-2255
- Fax : (608) 233-9342
- Phone : (608) 233-9167
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 5001291-015 | WI |
National Provider Identifier
| NPI | 1053400945 |
|---|---|
| Provider Name | Dr. Kenneth Donald Neidhart |
| First Address | Madison, WI 53705 |
| Second Address | Madison, WI 53705-2255 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/10/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| T62849 | (02) | WI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.