Provider Demographics
NPI:1265798854
Name:SCHMITTOU, KIMBERLY NEWMAN (DDS)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:NEWMAN
Last Name:SCHMITTOU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 N CROSBY AVE
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-3333
Mailing Address - Country:US
Mailing Address - Phone:608-752-7931
Mailing Address - Fax:
Practice Address - Street 1:107 N CROSBY AVE
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-3333
Practice Address - Country:US
Practice Address - Phone:608-752-7931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7121-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice