Active NPI
Susan Ann Cousineau
- Dental Hygienist
- Jackson, MI
National Provider Identifier
1952882995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2902003787
- Practice address
- 122 Highland Dr
Jackson, MI 49201-9164 - Phone
- (151) 774-0742
- Fax
- (517) 315-4918
- NPI assigned
- Aug 28, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 2902003787 | MI | Primary |
Addresses
Primary practice location
122 Highland Dr
Jackson, MI 49201-9164
Mailing address
3100 Thorntree Dr Apt 6
Gladstone, MI 49837-2479
Phone (517) 740-7422
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 |
|---|---|---|---|
| 2902003787 | MI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535414400000",
"number": "1952882995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 THORNTREE DR APT 6",
"city": "GLADSTONE",
"state": "MI",
"postal_code": "498372479",
"telephone_number": "517-740-7422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 HIGHLAND DR",
"city": "JACKSON",
"state": "MI",
"postal_code": "492019164",
"telephone_number": "151-774-0742",
"fax_number": "517-315-4918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COUSINEAU",
"first_name": "SUSAN",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-28",
"last_updated": "2018-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MI",
"license": "2902003787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.