Individual provider Active NPI

Lynette Leanor Llinas, R.D.H.

  • Dental Hygienist
  • Port Saint Lucie, FL
National Provider Identifier
1063720852
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DEH 18811 Issued in FL
Practice address
11307 SW Olmstead Dr
Port Saint Lucie, FL 34987-1947
Phone
(772) 345-0577
NPI assigned
Sep 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DEH 18811 FL Primary

Addresses

Primary practice location

11307 SW Olmstead Dr
Port Saint Lucie, FL 34987-1947

Mailing address

11307 SW Olmstead Dr
Port Saint Lucie, FL 34987-1947
Phone (772) 345-0577

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

LicenseStateTypeSpecialty
DEH 18811FLMDDental Hygienist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1063720852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11307 SW OLMSTEAD DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349871947",
            "telephone_number": "772-345-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11307 SW OLMSTEAD DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349871947",
            "telephone_number": "772-345-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLINAS",
        "first_name": "LYNETTE",
        "middle_name": "LEANOR",
        "credential": "R.D.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "FL",
            "license": "DEH 18811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; 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.