Active NPI
Fabiola Zamudio, RDH
- Dental Hygienist
- Detroit, MI
National Provider Identifier
1003114471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2902015931
- Practice address
- 559 W Grand Blvd
Detroit, MI 48216-2200 - Phone
- (313) 554-3880
- NPI assigned
- Mar 8, 2011
- Sex
- Female
- Sole proprietor
- No
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 | 2902015931 | MI | Primary |
Addresses
Primary practice location
559 W Grand Blvd
Detroit, MI 48216-2200
Mailing address
1921 Warwick Ave
Lincoln Park, MI 48146-4705
Phone (313) 645-9666
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 |
|---|---|---|---|
| 2902015931 | MI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299542400000",
"number": "1003114471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1921 WARWICK AVE",
"city": "LINCOLN PARK",
"state": "MI",
"postal_code": "481464705",
"telephone_number": "313-645-9666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "559 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482162200",
"telephone_number": "313-554-3880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZAMUDIO",
"first_name": "FABIOLA",
"name_prefix": "Miss",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-08",
"last_updated": "2011-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MI",
"license": "2902015931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.