Individual provider Active NPI

Annie Juergens, RDH

  • Dental Hygienist
  • Craig, CO
National Provider Identifier
1043724164
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH.002024901 Issued in CO
Practice address
745 Russell St
Craig, CO 81625-2019
Phone
(970) 824-8233
Fax
(970) 826-4164
NPI assigned
Nov 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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 DH.002024901 CO Primary

Addresses

Primary practice location

745 Russell St
Craig, CO 81625-2019

Mailing address

745 Russell St
Craig, CO 81625-2019
Phone (970) 824-8233

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

LicenseStateTypeSpecialty
DH.002024901COMDDental Hygienist

Interoperability endpoints

  • Direct secure messaging: annie.sadvar@nwcovna.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/GJDGAA/Endpoint/GJDGAA

NPI Registry JSON

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1043724164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 RUSSELL ST",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816252019",
            "telephone_number": "970-824-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 RUSSELL ST",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816252019",
            "telephone_number": "970-824-8233",
            "fax_number": "970-826-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUERGENS",
        "first_name": "ANNIE",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-28",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "DH.002024901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Craig, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; 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.