Active NPI
Jack Allen Cessna, RDH, BS
- Dental Hygienist
- Greeley, CO
National Provider Identifier
1003365404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH.002024533
- Practice address
- 1006 A St
Greeley, CO 80631-2021 - Phone
- (970) 352-0048
- NPI assigned
- Sep 26, 2016
- Sex
- Male
- 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 | DH.002024533 | CO | Primary |
Addresses
Primary practice location
1006 A St
Greeley, CO 80631-2021
Mailing address
2930 11TH Ave
Evans, CO 80620-1011
Phone (970) 350-4606
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DH.002024533 | CO | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunrise Community Health | Past | Accepting new patients | |
| Sunrise Community Health | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Greeley, CO
- NPI 1699073395
-
- Federally Qualified Health Center (FQHC)
- Loveland, CO
- NPI 1902005382
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475020800000",
"number": "1003365404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2930 11TH AVE",
"city": "EVANS",
"state": "CO",
"postal_code": "806201011",
"telephone_number": "970-350-4606",
"fax_number": "970-350-4645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1006 A ST",
"city": "GREELEY",
"state": "CO",
"postal_code": "806312021",
"telephone_number": "970-352-0048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CESSNA",
"first_name": "JACK",
"middle_name": "ALLEN",
"credential": "RDH, BS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-26",
"last_updated": "2016-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CO",
"license": "DH.002024533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.