Individual provider Active NPI

Diana L Whalen, RDH

  • Dental Hygienist
  • Beloit, WI
National Provider Identifier
1154764561
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
5955-16 Issued in WI
Practice address
74 Eclipse Ctr
Beloit, WI 53511-3550
Phone
(608) 299-3316
Fax
(608) 361-6131
NPI assigned
Apr 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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 5955-16 WI Primary

Addresses

Primary practice location

74 Eclipse Ctr
Beloit, WI 53511-3550

Mailing address

74 Eclipse Ctr
Beloit, WI 53511-3550
Phone (608) 299-3316

Other names 1

  • Diana L. Doubleday Former name

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
5955-16WIMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1154764561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 ECLIPSE CTR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535113550",
            "telephone_number": "608-299-3316",
            "fax_number": "608-361-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 ECLIPSE CTR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535113550",
            "telephone_number": "608-299-3316",
            "fax_number": "608-361-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEN",
        "first_name": "DIANA",
        "middle_name": "L",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-16",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WI",
            "license": "5955-16",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "DOUBLEDAY",
            "middle_name": "L.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beloit, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; 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.