Dinneshia Annetta Moten, DENTAL HYGIENIST

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

10503 Issued in TN

Practice address

Uss Osborne Dental Clinic
3440 Ohio St
Great Lakes, IL 60088

Phone

(847) 688-2100

NPI assigned

Dec 12, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1023825114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4113 SKATE CT APT A",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600881134",
            "telephone_number": "256-770-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USS OSBORNE DENTAL CLINIC",
            "address_2": "3440 OHIO ST",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "60088",
            "telephone_number": "847-688-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTEN",
        "first_name": "DINNESHIA",
        "middle_name": "ANNETTA",
        "credential": "DENTAL HYGIENIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "TN",
            "license": "10503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Thomas Minich, OTHER
• Milan Mitrovic, PH.D.
• Melanie Marie Fioramonti Mohler, PHARMD
• Peter Andrew Morawiecki, MD
• Eslin Louise Mornay, DDS
• Hudson Guy Motley, DDS
• Maria Mouchaham
• Clifford Loren Moudy II, I.D.C.
• James Patrick Muir, D.D.S.
• Jordan Munar

• Dental Hygienist in Great Lakes, IL
• Providers in Great Lakes, IL by specialty
• Dental Hygienist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.