Active NPI
Kara Mae McLellan, RDH
- Dental Hygienist
- Charlevoix, MI
National Provider Identifier
1891574828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2902018197
- Practice address
- 220 W Garfield Ave
Charlevoix, MI 49720-1631 - Phone
- (800) 432-4121
- NPI assigned
- Sep 28, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2902018197 | MI | Primary |
Addresses
Primary practice location
220 W Garfield Ave
Charlevoix, MI 49720-1631
Mailing address
825 Anderson Rd
Boyne City, MI 49712-8948
Phone (231) 350-0353
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2902018197 | MI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695859200000",
"number": "1891574828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 ANDERSON RD",
"city": "BOYNE CITY",
"state": "MI",
"postal_code": "497128948",
"telephone_number": "231-350-0353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 W GARFIELD AVE",
"city": "CHARLEVOIX",
"state": "MI",
"postal_code": "497201631",
"telephone_number": "800-432-4121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLELLAN",
"first_name": "KARA",
"middle_name": "MAE",
"name_prefix": "Mrs.",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-28",
"last_updated": "2023-09-28",
"certification_date": "2023-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MI",
"license": "2902018197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlevoix, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.