Provider Demographics
NPI:1114066362
Name:DENTAL HYGIENE LIMITED
Entity Type:Organization
Organization Name:DENTAL HYGIENE LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:CLAIRE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:RDHAP 4
Authorized Official - Phone:209-826-5992
Mailing Address - Street 1:863 I ST STE B
Mailing Address - Street 2:
Mailing Address - City:LOS BANOS
Mailing Address - State:CA
Mailing Address - Zip Code:93635-4310
Mailing Address - Country:US
Mailing Address - Phone:209-826-5992
Mailing Address - Fax:209-826-6268
Practice Address - Street 1:863 I ST STE B
Practice Address - Street 2:
Practice Address - City:LOS BANOS
Practice Address - State:CA
Practice Address - Zip Code:93635-4310
Practice Address - Country:US
Practice Address - Phone:209-826-5992
Practice Address - Fax:209-826-6268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDHAP 4124Q00000X
CARDHAP 5124Q00000X
CARDHAP 3124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAYO08234OtherDENTICAL
CAYO1864OtherDENTICAL
CAYO2283OtherDENTICAL