Active NPI
Heather Tedlock
- Dental Hygienist
- Pittsburg, KS
National Provider Identifier
1043882335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 12818
- Practice address
- 3011 N Michigan St
Pittsburg, KS 66762-2546 - Phone
- (620) 231-9873
- NPI assigned
- Jul 15, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 12818 | KS | Primary |
Addresses
Primary practice location
3011 N Michigan St
Pittsburg, KS 66762-2546
Mailing address
PO Box 1832
Pittsburg, KS 66762-1832
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12818 | KS | MD | Dental Hygienist |
Interoperability endpoints
- heather.tedlock@chcsek.eclinicaldirectplus.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626307200000",
"number": "1043882335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1832",
"city": "PITTSBURG",
"state": "KS",
"postal_code": "667621832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3011 N MICHIGAN ST",
"city": "PITTSBURG",
"state": "KS",
"postal_code": "667622546",
"telephone_number": "620-231-9873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEDLOCK",
"first_name": "HEATHER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-15",
"last_updated": "2021-07-15",
"certification_date": "2021-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "KS",
"license": "12818",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsburg, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.