Provider Demographics
NPI:1144366238
Name:DEHNERT, LINDA (DC)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:DEHNERT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825A S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-4633
Mailing Address - Country:US
Mailing Address - Phone:262-754-1211
Mailing Address - Fax:262-754-2911
Practice Address - Street 1:15400 W CAPITOL DR
Practice Address - Street 2:SUITE 202
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-2661
Practice Address - Country:US
Practice Address - Phone:262-754-1211
Practice Address - Fax:262-754-2911
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2404-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38920700Medicaid
WI000175153Medicare PIN
WIU43564Medicare UPIN