Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mackenzie Wickman

Individual provider Dental Hygienist · NPI 1104297571

Mackenzie Wickman is a Dental Hygienist in Lakewood, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2015.

Licensed in
WI
In the registry since
2015

Practice location Address checks out

15397 State Highway 32
Lakewood, WI 54138-9702
Phone: (715) 276-6321
Fax: (715) 276-1428
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Hygienist (primary) Taxonomy 124Q00000X · Licence 1002641 (WI)

Record details

NPI number1104297571
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 12, 2015
Last updated in NPPESOctober 31, 2024
Certification dateOctober 31, 2024
Mailing addressPo Box 179, Lakewood, WI 54138-0179

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