Active NPI
Kristin Mau
- General Practice Dentistry
- Potterville, MI
National Provider Identifier
1164631131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2901018615
- Practice address
- 400 S Nelson St
Potterville, MI 48876-8774 - Phone
- (517) 645-9980
- Fax
- (517) 645-9981
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901018615 | MI | Primary |
Addresses
Primary practice location
400 S Nelson St
Potterville, MI 48876-8774
Mailing address
400 S Nelson St
Potterville, MI 48876-8774
Phone (517) 645-9980
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150513002268 | MI | Order and Referring Only - Oral Surgery | 5698095750 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901018615 | MI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164631131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 S NELSON ST",
"city": "POTTERVILLE",
"state": "MI",
"postal_code": "488768774",
"telephone_number": "517-645-9980",
"fax_number": "517-645-9981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 S NELSON ST",
"city": "POTTERVILLE",
"state": "MI",
"postal_code": "488768774",
"telephone_number": "517-645-9980",
"fax_number": "517-645-9981"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAU",
"first_name": "KRISTIN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901018615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Potterville, MI
- Nicole Marie Guza, LLPC
- Healing Hands 4U2 Home Care LLC
- Healing Hands 4U2 Home Care LLC
- Jessica Rosenbrook Counseling Services LLC
- Richard Laurence Lezell, D.D.S.
- Elizabeth Marie McDowell, NP-C
- Mid Michigan General Dentistry
- Marissa Anne Miller, D.O.
- Hannah Myers-Southerly
- Kristine Kay Peterson, P.T.A
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.