Mildred Echevarria Thaw, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

012545 Issued in NY

Practice address

162 W 19TH St
Deer Park, NY 11729-4834

Phone

(516) 314-2827

NPI assigned

Jan 3, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Millie E Thaw Other name

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": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1053884973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DR. NICHOLAS TUCCI",
            "address_2": "800 COMMUNITY DRIVE",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "11030",
            "telephone_number": "516-466-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 W 19TH ST",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117294834",
            "telephone_number": "516-314-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAW",
        "first_name": "MILDRED",
        "middle_name": "ECHEVARRIA",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-03",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NY",
            "license": "012545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL HYGIENE LICENSE",
            "identifier": "012545",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MILLIE",
            "last_name": "THAW",
            "middle_name": "E",
            "prefix": "MRS.",
            "credential": "RDH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Dental Hygienist in Deer Park, NY
• Providers in Deer Park, NY by specialty
• Dental Hygienist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.