Individual provider Active NPI

Mary Ann Kovaleski, RDH

  • Dental Hygienist
  • Howell, MI
National Provider Identifier
1477054583
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
2902004205 Issued in MI
Practice address
3169 Charann Dr
Howell, MI 48843-8612
Phone
(517) 546-7920
NPI assigned
Feb 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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 2902004205 MI Primary

Addresses

Primary practice location

3169 Charann Dr
Howell, MI 48843-8612

Mailing address

3169 Charann Dr
Howell, MI 48843-8612
Phone (517) 546-7920

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
2902004205MIMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1477054583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3169 CHARANN DR",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488438612",
            "telephone_number": "517-546-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3169 CHARANN DR",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488438612",
            "telephone_number": "517-546-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVALESKI",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-23",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MI",
            "license": "2902004205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howell, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; 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.