Individual provider Active NPI

Diana Lee Kott, RDH

  • Dental Hygienist
  • Selfridge Angb, MI
National Provider Identifier
1528409117
Registry record updated Jul 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
2902011643 Issued in MI
Practice address
43401 N Jefferson Ave BLDG 825
Selfridge Angb, MI 48045-5266
Phone
(586) 239-3005
NPI assigned
Jul 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2013

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 2902011643 MI Primary

Addresses

Primary practice location

43401 N Jefferson Ave BLDG 825
Selfridge Angb, MI 48045-5266

Mailing address

43401 N Jefferson Ave BLDG 825
Selfridge Angb, MI 48045-5266
Phone (586) 239-3005

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
2902011643MIMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Uscg Detroit Pharmacy PastSince Oct 31, 2021 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": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373500800000",
    "number": "1528409117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43401 N JEFFERSON AVE BLDG 825",
            "city": "SELFRIDGE ANGB",
            "state": "MI",
            "postal_code": "480455266",
            "telephone_number": "586-239-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43401 N JEFFERSON AVE BLDG 825",
            "city": "SELFRIDGE ANGB",
            "state": "MI",
            "postal_code": "480455266",
            "telephone_number": "586-239-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTT",
        "first_name": "DIANA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-11",
        "last_updated": "2013-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MI",
            "license": "2902011643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Selfridge Angb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2013; 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.