Active NPI
Jacqueline Ann Boice, RDH
- Dental Hygienist
- Peshtigo, WI
National Provider Identifier
1346695798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2902017784
- Practice address
- 800 Kennedy CT
Peshtigo, WI 54157-1026 - Phone
- (715) 938-0490
- NPI assigned
- May 3, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2902017784 | MI | Primary |
| Dental Hygienist | 124Q00000X | 6886016 | WI |
Addresses
Primary practice location
800 Kennedy CT
Peshtigo, WI 54157-1026
Mailing address
800 Kennedy CT
Peshtigo, WI 54157-1026
Phone (715) 938-0490
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 |
|---|---|---|---|
| 2902017784 | MI | MD | Dental Hygienist |
| 6886016 | WI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462233600000",
"number": "1346695798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 KENNEDY CT",
"city": "PESHTIGO",
"state": "WI",
"postal_code": "541571026",
"telephone_number": "715-938-0490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 KENNEDY CT",
"city": "PESHTIGO",
"state": "WI",
"postal_code": "541571026",
"telephone_number": "715-938-0490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOICE",
"first_name": "JACQUELINE",
"middle_name": "ANN",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-03",
"last_updated": "2016-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MI",
"license": "2902017784",
"primary": true
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WI",
"license": "6886016",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peshtigo, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.