Individual provider Active NPI

Marissa Petrice Swab, RDH

  • Dental Hygienist
  • Lansing, MI
National Provider Identifier
1891355632
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
2902018993 Issued in MI
Practice address
5135 S Pennsylvania Ave
Lansing, MI 48911-4002
Phone
(517) 272-5053
NPI assigned
Jun 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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 2902018993 MI Primary

Addresses

Primary practice location

5135 S Pennsylvania Ave
Lansing, MI 48911-4002

Mailing address

5135 S Pennsylvania Ave
Lansing, MI 48911-4002
Phone (517) 272-5053

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
2902018993MIMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1891355632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5135 S PENNSYLVANIA AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114002",
            "telephone_number": "517-272-5053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5135 S PENNSYLVANIA AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114002",
            "telephone_number": "517-272-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAB",
        "first_name": "MARISSA",
        "middle_name": "PETRICE",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MI",
            "license": "2902018993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.