Individual provider Active NPI

Rachael Leigh Michalak, DDS

  • Dentist
  • Toledo, OH
National Provider Identifier
1144531922
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.023249 Issued in OH
Practice address
2138 Madison Ave
Toledo, OH 43604-5131
Phone
(419) 241-1644
Fax
(419) 249-6581
NPI assigned
Jun 28, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.023249 OH Primary
General Practice Dentistry 1223G0001X 30.023249 OH

Addresses

Primary practice location

2138 Madison Ave
Toledo, OH 43604-5131

Mailing address

12130 Pebble Hills Blvd Apt H305
El Paso, TX 79936-1032
Phone (419) 367-0445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180727002421 OH Order and Referring Only - DentistPractitioner - Dentist 4082961651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.023249OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1144531922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12130 PEBBLE HILLS BLVD APT H305",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799361032",
            "telephone_number": "419-367-0445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2138 MADISON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436045131",
            "telephone_number": "419-241-1644",
            "fax_number": "419-249-6581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALAK",
        "first_name": "RACHAEL",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.023249",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.023249",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.