Provider Demographics
NPI:1255937587
Name:HELLEIN, DARLENE ROSE (RDHAP)
Entity type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:ROSE
Last Name:HELLEIN
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1184 BROOKMEADE CIR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-7024
Mailing Address - Country:US
Mailing Address - Phone:951-640-8694
Mailing Address - Fax:
Practice Address - Street 1:1184 BROOKMEADE CIR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-7024
Practice Address - Country:US
Practice Address - Phone:951-640-8694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA768124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist