Elevate Dental Hygiene LLC

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

Legal business name

ELEVATE DENTAL HYGIENE LLC

Practice address

630 Sun Valley Road Suite D102
Ketchum, ID 83340

Phone

(208) 731-8723

NPI assigned

Jan 11, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michelle Watkins, RDHNPI 1649898578

Title

Owner

Phone

(208) 731-8723

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle Ann Watkins, RDH

  • Dental Hygienist
  • Hailey, ID
  • NPI 1649898578
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1013506591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 NORTHSTAR DR",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338501",
            "telephone_number": "208-731-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 SUN VALLEY ROAD SUITE D102",
            "city": "KETCHUM",
            "state": "ID",
            "postal_code": "83340",
            "telephone_number": "208-731-8723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATE DENTAL HYGIENE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-731-8723",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1851496137",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1649898578",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Dettori, RN
• Kelly Dilorenzo, M.D.
• John Driscoll, CRNA
• Karoline A Droege, MPT
• Christopher Williams Dunn
• Cathryn Erickson, DO
• Kerri Everett, SLP
• Eyecenter PA (Ketchum Eyecenter)
• Dan S Fairman, MD
• Family Medicine & Medicine

• Dental Hygienist in Ketchum, ID
• Providers in Ketchum, ID by specialty
• Dental Hygienist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.