Individual provider Active NPI

Melissa Ann Yeager

  • Dental Hygienist
  • Green Bay, WI
National Provider Identifier
1154870228
Registry record updated Sep 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
1002827 Issued in WI
Practice address
1931 Main St
Green Bay, WI 54302-3920
Phone
(888) 988-4066
NPI assigned
Sep 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2016

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 1002827 WI Primary

Addresses

Primary practice location

1931 Main St
Green Bay, WI 54302-3920

Mailing address

2050 E Algonquin Rd
Schaumburg, IL 60173-4144
Phone (847) 915-3044

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
1002827WIMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Familia Dental Green Bay East LLC PastSince Jun 27, 2021 Accepting new patients
Familia Dental Mkemidtown LLC Past Accepting new patients
Familia Dental Mkemitchell LLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1154870228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 E ALGONQUIN RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734144",
            "telephone_number": "847-915-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 MAIN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543023920",
            "telephone_number": "888-988-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEAGER",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-29",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WI",
            "license": "1002827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; 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.