Krystal L Anson, RDH
Individual provider Active NPI Dental Hygienist · Canton, NY
NPI 1063248557 · NPPES record last updated Sep 11, 2024
Key facts
- NPI
- 1063248557
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 025701-01 (NY)
- Practice address
- 4 Commerce LN
Canton, NY 13617-3739 - Phone
- (315) 379-8100
- NPI assigned
- Sep 11, 2024
- 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 |
|---|---|---|---|
| 025701-01 | NY | MD | Hand Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 025701-01 | NY | Yes |
Addresses
Primary practice location
4 Commerce LN
Canton, NY 13617-3739
Mailing address
503 Howardville Rd
Canton, NY 13617-3439
Phone (315) 783-2023
Other providers in Canton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2024. 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.