Individual provider Active NPI

Sally Zager, R.D.H.

  • Dental Hygienist
  • Black River Falls, WI
National Provider Identifier
1407990096
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
6153-016 Issued in WI
Practice address
N6520 Guy Rd
Black River Falls, WI 54615-5405
Phone
(715) 284-9851
Fax
(715) 284-4574
NPI assigned
Feb 16, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 6153-016 WI Primary

Addresses

Primary practice location

N6520 Guy Rd
Black River Falls, WI 54615-5405

Mailing address

N6520 Guy Rd
Black River Falls, WI 54615-5405
Phone (715) 284-9851

Other identifiers 1

IdentifierTypeStateIssuer
33808500MedicaidWI

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

LicenseStateTypeSpecialty
6153-016WIMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Ho-Chunk Nation Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407990096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N6520 GUY RD",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546155405",
            "telephone_number": "715-284-9851",
            "fax_number": "715-284-4574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N6520 GUY RD",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546155405",
            "telephone_number": "715-284-9851",
            "fax_number": "715-284-4574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAGER",
        "first_name": "SALLY",
        "name_prefix": "Ms.",
        "credential": "R.D.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WI",
            "license": "6153-016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33808500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Black River Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.