Individual provider Active NPI

Mary Allison Harper, DMD

  • General Practice Dentistry
  • Hayward, WI
National Provider Identifier
1205957594
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6987 Issued in ID
Practice address
9940 N County Hwy K
Hayward, WI 54843-2186
Phone
(715) 638-5144
Fax
(715) 634-9919
NPI assigned
Apr 3, 2007
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN17548 FL
General Practice Dentistry 1223G0001X 6987 ID Primary

Addresses

Primary practice location

9940 N County Hwy K
Hayward, WI 54843-2186

Mailing address

9940 N County Hwy K
Hayward, WI 54843-2186
Phone (715) 638-5144

Other identifiers 2

IdentifierTypeStateIssuer
1205957594MedicaidWI
807490600MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170419000984 WI Order and Referring Only - Other (Non-Physician) 5193001543

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN17548FLMDGeneral Practice Dentistry
6987IDMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1205957594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9940 N COUNTY HWY K",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548432186",
            "telephone_number": "715-638-5144",
            "fax_number": "715-634-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9940 N COUNTY HWY K",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548432186",
            "telephone_number": "715-638-5144",
            "fax_number": "715-634-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARPER",
        "first_name": "MARY",
        "middle_name": "ALLISON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2025-06-02",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17548",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "6987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205957594",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807490600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, WI

Sources for this page

Verify at the official NPI Registry.