Elizabeth Jene Ezell, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

0402207520 Issued in VA

Practice address

604 N. Thomas St.
South Hill, VA 23970

Phone

(434) 447-4464

Fax

(434) 447-2249

NPI assigned

Jan 17, 2019

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

State licenses

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1043784606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O.B. 599",
            "address_2": "604 N. THOMAS ST.",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "23970",
            "telephone_number": "434-447-4464",
            "fax_number": "434-447-2249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 N. THOMAS ST.",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "23970",
            "telephone_number": "434-447-4464",
            "fax_number": "434-447-2249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZELL",
        "first_name": "ELIZABETH",
        "middle_name": "JENE",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "VA",
            "license": "0402207520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Hygienist in South Hill, VA
• Providers in South Hill, VA by specialty
• Dental Hygienist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; 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.