Active NPI
Mary Kourakin, RDH
- Dental Hygienist
- Millville, NJ
National Provider Identifier
1346645850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 22HI00343600
- Practice address
- 16 W Vine St
Millville, NJ 08332-3823 - Phone
- (856) 825-0618
- NPI assigned
- Oct 27, 2014
- 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 | 22HI00343600 | NJ | Primary |
Addresses
Primary practice location
16 W Vine St
Millville, NJ 08332-3823
Mailing address
404 Highland Dr
Mays Landing, NJ 08330-1649
Phone (609) 442-3075
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 |
|---|---|---|---|
| 22HI00343600 | NJ | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414368000000",
"number": "1346645850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 HIGHLAND DR",
"city": "MAYS LANDING",
"state": "NJ",
"postal_code": "083301649",
"telephone_number": "609-442-3075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 W VINE ST",
"city": "MILLVILLE",
"state": "NJ",
"postal_code": "083323823",
"telephone_number": "856-825-0618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOURAKIN",
"first_name": "MARY",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-27",
"last_updated": "2014-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NJ",
"license": "22HI00343600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Millville, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.