Clarissa Jimenez, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

DH60386410 Issued in WA

Practice address

140 E Main St
Othello, WA 99344-1040

Phone

(509) 488-5256

Fax

(509) 488-9939

NPI assigned

Sep 30, 2013

Last updated

Sep 30, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Clarissa Garza Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1063849529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 E MAIN ST",
            "city": "OTHELLO",
            "state": "WA",
            "postal_code": "993441040",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 E MAIN ST",
            "city": "OTHELLO",
            "state": "WA",
            "postal_code": "993441040",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "CLARISSA",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-30",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "DH60386410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLARISSA",
            "last_name": "GARZA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sonia Veronica Idrogo, DMD
• Inland Northwest Renal Care Group, LLC (Fresenius Medical Care Leah Layne Dialysis Clinic)
• Andrew Robert Jacobson, PHARMACIST
• Douglas Ray Jahns, ARNP
• Mishka K James, PA-C
• Manuel Jimenez, DDS
• Richard Jimenez, D.M.D.
• Aaron Ross Jones, MSW
• Kenneth Jones, PT
• Ravichandra Kamisetti

• Dental Hygienist in Othello, WA
• Providers in Othello, WA by specialty
• Dental Hygienist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.