Sanka Divic, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

2902014498 Issued in MI

Practice address

2055 Rosewood Ave SE
Grand Rapids, MI 49506-5248

Phone

(616) 776-5110

NPI assigned

Nov 5, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sanka.divic.p1@direct.cherryhealth.nextgenshare.com

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

• Cherry Street Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Howard City, MI
  • NPI 1831955251
  NPD (past)
• Cherry Street Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Grand Rapids, MI
  • NPI 1124187471
  NPD (past)

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1679946263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2453 BLUFF MEADOWS DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467910",
            "telephone_number": "616-956-9265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 ROSEWOOD AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495065248",
            "telephone_number": "616-776-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVIC",
        "first_name": "SANKA",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-05",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MI",
            "license": "2902014498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Kenneth Distler
• Danielle Erin Jo Ditrapani
• Diana Gayl Ditrapani, MSW, LMSW
• Adam Diver, PT, DPT
• Josip Divic, MD
• Divine Hands Doula Care
• Divine Mind Counseling and Consulting Services
• Nicole Kristine Divita
• Annessa M Dix, OD
• Janelle Dixon

• Dental Hygienist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Dental Hygienist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.