Brenda Jean Quilling-Davis, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

IL 60433058 Issued in WA

Practice address

30400 NE Ireland Rd
Camas, WA 98607-9606

Phone

(360) 989-6065

Fax

(360) 834-0508

NPI assigned

Feb 2, 2015

Last updated

Feb 2, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1422835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422835200000",
    "number": "1104216811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30400 NE IRELAND RD",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986079606",
            "telephone_number": "360-989-6065",
            "fax_number": "360-834-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30400 NE IRELAND RD",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986079606",
            "telephone_number": "360-989-6065",
            "fax_number": "360-834-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUILLING-DAVIS",
        "first_name": "BRENDA",
        "middle_name": "JEAN",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-02",
        "last_updated": "2015-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "IL 60433058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.