Individual provider Active NPI

Neil William Edens

  • Dental Hygienist
  • Iron Mountain, MI
National Provider Identifier
1073020723
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH012993 Issued in GA
Practice address
325 E H St
Iron Mountain, MI 49801-4760
Phone
(906) 774-3300
NPI assigned
Jan 3, 2018
Last updated
Jan 3, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH012993 GA Primary

Addresses

Primary practice location

325 E H St
Iron Mountain, MI 49801-4760

Mailing address

133 Birch St
Kingsford, MI 49802-5219
Phone (478) 595-5156

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

LicenseStateTypeSpecialty
DH012993GAMDDental Hygienist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1073020723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 BIRCH ST",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498025219",
            "telephone_number": "478-595-5156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 E H ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498014760",
            "telephone_number": "906-774-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDENS",
        "first_name": "NEIL",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "GA",
            "license": "DH012993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.