Active NPI
Dominique Taylor Otto, RDH
- Dental Hygienist
- Macomb, MI
National Provider Identifier
1205543733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- Practice address
- 52856 Hayes Rd
Macomb, MI 48042-3507 - Phone
- (586) 697-5272
- NPI assigned
- Nov 3, 2022
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | Primary |
Addresses
Primary practice location
52856 Hayes Rd
Macomb, MI 48042-3507
Mailing address
52856 Hayes Rd
Macomb, MI 48042-3507
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Virtru | Health Information Exchange (HIE) |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667433600000",
"number": "1205543733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "52856 HAYES RD",
"city": "MACOMB",
"state": "MI",
"postal_code": "480423507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "52856 HAYES RD",
"city": "MACOMB",
"state": "MI",
"postal_code": "480423507",
"telephone_number": "586-697-5272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTTO",
"first_name": "DOMINIQUE",
"middle_name": "TAYLOR",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-03",
"last_updated": "2022-11-03",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Virtru",
"affiliation": "N",
"endpointDescription": "Encription",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "52856 Hayes Rd",
"city": "Macomb",
"state": "MI",
"country_code": "US",
"postal_code": "480423507",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Macomb, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.