Provider Demographics
NPI:1184284259
Name:HIGDEM, KARI MARIE (DDS)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:MARIE
Last Name:HIGDEM
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 1:30935 ZEPHYR VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:RUSHFORD
Mailing Address - State:MN
Mailing Address - Zip Code:55971-4212
Mailing Address - Country:US
Mailing Address - Phone:320-262-9315
Mailing Address - Fax:
Practice Address - Street 1:3132 MARKET PL
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-6705
Practice Address - Country:US
Practice Address - Phone:608-783-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WI1002137-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program