Active NPI
Devan Michelle Toberman, RDH
- Dental Hygienist
- Boscobel, WI
National Provider Identifier
1336397900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 124Q00000X
- Practice address
- 109 E Bluff St
Boscobel, WI 53805-1610 - Phone
- (608) 326-8210
- NPI assigned
- Sep 8, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 124Q00000X | WI | Primary |
Addresses
Primary practice location
109 E Bluff St
Boscobel, WI 53805-1610
Mailing address
109 E Bluff St
Boscobel, WI 53805-1610
Phone (608) 326-8210
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33828700 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 124Q00000X | WI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220832000000",
"number": "1336397900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 E BLUFF ST",
"city": "BOSCOBEL",
"state": "WI",
"postal_code": "538051610",
"telephone_number": "608-326-8210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 E BLUFF ST",
"city": "BOSCOBEL",
"state": "WI",
"postal_code": "538051610",
"telephone_number": "608-326-8210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOBERMAN",
"first_name": "DEVAN",
"middle_name": "MICHELLE",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-08",
"last_updated": "2008-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WI",
"license": "124Q00000X",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "33828700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boscobel, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.