Individual provider Active NPI

Mariah Rae Sullinger, RDH

  • Dental Hygienist
  • Aurora, CO
National Provider Identifier
1457806333
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH.002024716 Issued in CO
Practice address
3292 Peoria St
Aurora, CO 80010
Phone
(303) 360-6276
NPI assigned
Aug 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X H9789 MN
Dental Hygienist 124Q00000X DH.002024716 CO Primary

Addresses

Primary practice location

3292 Peoria St
Aurora, CO 80010

Mailing address

3701 S Broadway
Englewood, CO 80113-3611
Phone (303) 360-6276

Other practice location 1

115 Drew Ave SE
#202
Madelia, MN 56062-1873
Phone (507) 642-8742

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
H9789MNMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1457806333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 S BROADWAY",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133611",
            "telephone_number": "303-360-6276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3292 PEORIA ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80010",
            "telephone_number": "303-360-6276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Drew Ave SE",
            "address_2": "#202",
            "address_purpose": "LOCATION",
            "city": "Madelia",
            "state": "MN",
            "postal_code": "560621873",
            "country_code": "US",
            "telephone_number": "507-642-8742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLINGER",
        "first_name": "MARIAH",
        "middle_name": "RAE",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-19",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MN",
            "license": "H9789",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "DH.002024716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; 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.