Active NPI
Lana Jarjis, RDH
- Dental Hygienist
- Peoria, AZ
National Provider Identifier
1104119858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 5845
- Practice address
- 15182 N 75TH Ave
Suite 120
Peoria, AZ 85381-4722 - Phone
- (623) 878-2400
- NPI assigned
- May 26, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 5845 | AZ | Primary |
| Dental Hygienist | 124Q00000X | 020010334 | IL |
Addresses
Primary practice location
15182 N 75TH Ave
Suite 120
Peoria, AZ 85381-4722
Mailing address
15182 N 75TH Ave
Suite 120
Peoria, AZ 85381-4722
Phone (623) 878-2400
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 |
|---|---|---|---|
| 5845 | AZ | MD | Dental Hygienist |
| 020010334 | IL | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306368000000",
"number": "1104119858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15182 N 75TH AVE",
"address_2": "SUITE 120",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853814722",
"telephone_number": "623-878-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15182 N 75TH AVE",
"address_2": "SUITE 120",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853814722",
"telephone_number": "623-878-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JARJIS",
"first_name": "LANA",
"name_prefix": "Mrs.",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-26",
"last_updated": "2011-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "AZ",
"license": "5845",
"primary": true
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "IL",
"license": "020010334",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.