Individual provider Active NPI

Kathina Justice, R.D.H., A.S.

  • Dental Hygienist
  • McMinnville, OR
National Provider Identifier
1043644685
Registry record updated Aug 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
H6511 Issued in OR
Practice address
1896 NE Lucy Belle St
McMinnville, OR 97128-9259
Phone
(503) 435-9542
NPI assigned
Aug 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X H6511 OR Primary

Addresses

Primary practice location

1896 NE Lucy Belle St
McMinnville, OR 97128-9259

Mailing address

1896 NE Lucy Belle St
McMinnville, OR 97128-9259
Phone (503) 435-9542

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
Associate of Science

State licenses

LicenseStateTypeSpecialty
H6511ORMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1377907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377907200000",
    "number": "1043644685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1896 NE LUCY BELLE ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971289259",
            "telephone_number": "503-435-9542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1896 NE LUCY BELLE ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971289259",
            "telephone_number": "503-435-9542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "KATHINA",
        "name_prefix": "Mrs.",
        "credential": "R.D.H., A.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-31",
        "last_updated": "2013-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OR",
            "license": "H6511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2013; 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.