Individual provider Active NPI

Diane K Callahan, RDH

  • Dental Hygienist
  • Beloit, WI
National Provider Identifier
1942441944
Registry record updated Mar 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
5539016 Issued in WI
Practice address
74 Eclipse Ctr
Beloit, WI 53511-3550
Phone
(608) 361-6048
NPI assigned
Mar 20, 2009
Last updated
Mar 20, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2009

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 5539016 WI Primary

Addresses

Primary practice location

74 Eclipse Ctr
Beloit, WI 53511-3550

Mailing address

74 Eclipse Ctr
Beloit, WI 53511-3550
Phone (608) 361-6048

Other identifiers 1

IdentifierTypeStateIssuer
5539016OtherWISTATE OF WISCONSIN LICENSE NUMBER

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
5539016WIMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1237507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237507200000",
    "number": "1942441944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 ECLIPSE CTR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535113550",
            "telephone_number": "608-361-6048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 ECLIPSE CTR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535113550",
            "telephone_number": "608-361-6048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "DIANE",
        "middle_name": "K",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-20",
        "last_updated": "2009-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WI",
            "license": "5539016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WISCONSIN LICENSE NUMBER",
            "identifier": "5539016",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2009; 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.