Active NPI
Mariah M Mayne, RDH
- Dental Hygienist
- Boscobel, WI
National Provider Identifier
1013511872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 1003723
- Practice address
- 105 E Bluff St
Boscobel, WI 53805-1610 - Phone
- (608) 654-5100
- Fax
- (608) 654-7408
- NPI assigned
- Nov 23, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 1003723 | WI | Primary |
Addresses
Primary practice location
105 E Bluff St
Boscobel, WI 53805-1610
Mailing address
PO Box 39
Cashton, WI 54619-0039
Phone (608) 654-5100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1003723 | WI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606089600000",
"number": "1013511872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 39",
"city": "CASHTON",
"state": "WI",
"postal_code": "546190039",
"telephone_number": "608-654-5100",
"fax_number": "608-654-7408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 E BLUFF ST",
"city": "BOSCOBEL",
"state": "WI",
"postal_code": "538051610",
"telephone_number": "608-654-5100",
"fax_number": "608-654-7408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYNE",
"first_name": "MARIAH",
"middle_name": "M",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-23",
"last_updated": "2020-11-23",
"certification_date": "2020-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WI",
"license": "1003723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boscobel, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.