Individual provider Active NPI

Jennifer Q Tuazon, RDH

  • Dental Hygienist
  • Woodland, CA
National Provider Identifier
1083176903
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
26591 Issued in CA
Practice address
1820 Kelley PL
Woodland, CA 95776-5446
Phone
(415) 806-9005
NPI assigned
Apr 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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 26591 CA Primary

Addresses

Primary practice location

1820 Kelley PL
Woodland, CA 95776-5446

Mailing address

1820 Kelley PL
Woodland, CA 95776-5446
Phone (415) 806-9005

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
26591CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1083176903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 KELLEY PL",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "957765446",
            "telephone_number": "415-806-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 KELLEY PL",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "957765446",
            "telephone_number": "415-806-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUAZON",
        "first_name": "JENNIFER",
        "middle_name": "Q",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "26591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; 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.