Provider Demographics
NPI:1083369193
Name:ESTEP, KIRSTEN JEAN (BSW, RDH)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:JEAN
Last Name:ESTEP
Suffix:
Gender:F
Credentials:BSW, RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15066 GRINDSTONE LN
Mailing Address - Street 2:
Mailing Address - City:FULKS RUN
Mailing Address - State:VA
Mailing Address - Zip Code:22830-2230
Mailing Address - Country:US
Mailing Address - Phone:814-279-2794
Mailing Address - Fax:
Practice Address - Street 1:1380 LITTLE SORRELL DR STE 100
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-7372
Practice Address - Country:US
Practice Address - Phone:540-236-3688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0402208072124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist