Individual provider Active NPI

Hannah Grace Taw, DMD

  • General Practice Dentistry
  • Pewaukee, WI
National Provider Identifier
1528635612
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6001033-15 Issued in WI
Practice address
1231 George Towne Dr Ste D
Pewaukee, WI 53072-2756
Phone
(262) 691-9832
Fax
(262) 691-9871
NPI assigned
Jun 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6001033-15 WI
Dentist 122300000X 10584 KY
General Practice Dentistry 1223G0001X 6001033-15 WI Primary

Addresses

Primary practice location

1231 George Towne Dr Ste D
Pewaukee, WI 53072-2756

Mailing address

10105 John Ashley CT
Louisville, KY 40299-5867
Phone (901) 355-9445

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
10584KYMDDentist
6001033-15WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1528635612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10105 JOHN ASHLEY CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402995867",
            "telephone_number": "901-355-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 GEORGE TOWNE DR STE D",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530722756",
            "telephone_number": "262-691-9832",
            "fax_number": "262-691-9871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAW",
        "first_name": "HANNAH",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6001033-15",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "10584",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6001033-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pewaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; 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.