Marissa Harrell, RDH, PHDH
Individual provider Active NPI Dental Hygienist · Litchfield, IL
NPI 1063197937 · NPPES record last updated Jun 19, 2023
Key facts
- NPI
- 1063197937
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 020016072 (IL)
- Practice address
- 125 W Columbian Blvd S
Litchfield, IL 62056-3021 - Phone
- (217) 250-2360
- NPI assigned
- Jun 19, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020016072 | IL | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 020016072 | IL | Yes |
Addresses
Primary practice location
125 W Columbian Blvd S
Litchfield, IL 62056-3021
Mailing address
12228 Meisenheimer Ave
Hillsboro, IL 62049-3004
Phone (217) 556-5014
Other providers in Litchfield, IL
- Corrina G Griffiths
- Jennifer M Gudgel
- Kristin Hagopian
- Kelley Lee Halliburton
- Christine Marie Harms
- Health Plus of Illinois Inc
- Richard Charles Heller
- Heritage Manor - Litchfield, LLC
- Heritage Manor Litchfield, LLC
- Jennifer Lynn Hewing
All providers in Litchfield, IL · Dental Hygienist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.