Active NPI
Vanessa R Martin, RDH
- Dental Hygienist
- Lancaster, WI
National Provider Identifier
1104147768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 10572-016
- Practice address
- 111 S Jefferson St
Lancaster, WI 53813-1666 - Phone
- (608) 723-6416
- Fax
- (608) 723-6501
- NPI assigned
- Jun 17, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 10572-016 | WI | Primary |
Addresses
Primary practice location
111 S Jefferson St
Lancaster, WI 53813-1666
Mailing address
111 S Jefferson St
Lancaster, WI 53813-1666
Phone (608) 723-6416
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 |
|---|---|---|---|
| 10572-016 | WI | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Grant | Past | Accepting new patients | |
| County of Grant | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Home Health Agency
- Lancaster, WI
- NPI 1710047923
-
- Community Based Hospice Care Agency
- Lancaster, WI
- NPI 1841359536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276732800000",
"number": "1104147768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 S JEFFERSON ST",
"city": "LANCASTER",
"state": "WI",
"postal_code": "538131666",
"telephone_number": "608-723-6416",
"fax_number": "608-723-6501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 S JEFFERSON ST",
"city": "LANCASTER",
"state": "WI",
"postal_code": "538131666",
"telephone_number": "608-723-6416",
"fax_number": "608-723-6501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "VANESSA",
"middle_name": "R",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-17",
"last_updated": "2010-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WI",
"license": "10572-016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lancaster, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.