IndividualActive
Amanda Kositzke, RDH
NPI 1790590396 · Dental Hygienist · Waukesha, WI
Provider details
- NPI number
- 1790590396
- Entity type
- Individual
- Primary specialty
- Dental HygienistDental Providers
- Credential
- RDH
- Sex
- Female
- Sole proprietor
- Yes
- License
- 124Q00000X (WI)
Specialties & taxonomies
Dental Providers
Dental Providers
Practice location
711 W Moreland Blvd Ste 204
Waukesha, WI 53188-2483
Phone: (262) 896-9891
Approximate (ZIP-level) locationGet directions
Mailing address
711 W Moreland Blvd Ste 204
Waukesha, WI 53188-2483
Registry dates
- Enumerated
- 2025-02-11
- Last updated
- 2025-02-11
- Certified
- 2025-02-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.