Provider Demographics
NPI:1417469206
Name:DRINNON, KRISTIN LARAE (RDH)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LARAE
Last Name:DRINNON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1488 RIVERPARK PKWY
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:NV
Mailing Address - Zip Code:89403-6332
Mailing Address - Country:US
Mailing Address - Phone:775-217-0600
Mailing Address - Fax:
Practice Address - Street 1:1488 RIVERPARK PKWY
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:NV
Practice Address - Zip Code:89403-6332
Practice Address - Country:US
Practice Address - Phone:775-217-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV101858124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist