Active NPI
Jessica J Overton, RDH
- Dental Hygienist
- Pulaski, NY
National Provider Identifier
1063644292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 023797
- Practice address
- 61 Delano St
Pulaski, NY 13142-1400 - Phone
- (315) 298-6815
- Fax
- (315) 298-7488
- NPI assigned
- Aug 21, 2009
- 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 | 023797 | NY | Primary |
Addresses
Primary practice location
61 Delano St
Pulaski, NY 13142-1400
Mailing address
61 Delano St
Pulaski, NY 13142-1400
Phone (315) 298-6815
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00023797 | Medicaid | NY |
Other names 1
- Jessica J Hall
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250812800000",
"number": "1063644292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "61 DELANO ST",
"city": "PULASKI",
"state": "NY",
"postal_code": "131421400",
"telephone_number": "315-298-6815",
"fax_number": "315-298-7488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61 DELANO ST",
"city": "PULASKI",
"state": "NY",
"postal_code": "131421400",
"telephone_number": "315-298-6815",
"fax_number": "315-298-7488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OVERTON",
"first_name": "JESSICA",
"middle_name": "J",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-21",
"last_updated": "2009-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NY",
"license": "023797",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00023797",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "HALL",
"middle_name": "J",
"credential": "RCH",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Pulaski, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.