Active NPI
Jennifer Van
- Dental Hygienist
- Stanton, CA
National Provider Identifier
1073983250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- RDHAP 628
- Practice address
- 10882 Cedar Street
Stanton, CA 90680 - Phone
- (714) 365-6739
- NPI assigned
- Oct 1, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 27562 | CA | |
| Dental Hygienist | 124Q00000X | RDHAP 628 | CA | Primary |
Addresses
Primary practice location
10882 Cedar Street
Stanton, CA 90680
Mailing address
10882 Cedar Street
Stanton, CA 90680
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
| License | State | Type | Specialty |
|---|---|---|---|
| RDHAP 628 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473465600000",
"number": "1073983250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10882 CEDAR STREET",
"city": "STANTON",
"state": "CA",
"postal_code": "90680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10882 CEDAR STREET",
"city": "STANTON",
"state": "CA",
"postal_code": "90680",
"telephone_number": "714-365-6739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-01",
"last_updated": "2016-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "27562",
"primary": false
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "RDHAP 628",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stanton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.