Individual provider Active NPI

Ann M Polich, RDH

  • Dental Hygienist
  • Sheboygan, WI
National Provider Identifier
1174897656
Registry record updated Mar 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
5408 Issued in WI
Practice address
510 S. 8TH St.
Sheboygan, WI 53081
Phone
(920) 320-6775
NPI assigned
Mar 1, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2014

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 5408 WI Primary

Addresses

Primary practice location

510 S. 8TH St.
Sheboygan, WI 53081

Mailing address

510 S. 8TH St.
Sheboygan, WI 53081
Phone (920) 783-6633

Other names 1

  • Miss Ann M Rank 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
5408WIMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1174897656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 S. 8TH ST.",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "53081",
            "telephone_number": "920-783-6633",
            "fax_number": "920-783-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S. 8TH ST.",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "53081",
            "telephone_number": "920-320-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLICH",
        "first_name": "ANN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-01",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WI",
            "license": "5408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "RANK",
            "middle_name": "M",
            "prefix": "MISS",
            "credential": "RDH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; 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.