Jessica Arevalo, RDH
Individual provider Active NPI Dental Hygienist · New Hartford, NY
NPI 1104284769 · NPPES record last updated Feb 10, 2016
Key facts
- NPI
- 1104284769
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 022595-1 (NY)
- Practice address
- 2050 Tilden Ave
New Hartford, NY 13413-3613 - Phone
- (315) 737-2448
- NPI assigned
- Feb 10, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022595-1 | NY | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 022595-1 | NY | Yes |
Addresses
Primary practice location
2050 Tilden Ave
New Hartford, NY 13413-3613
Mailing address
2050 Tilden Ave
PO Box 1000
New Hartford, NY 13413-3613
Phone (315) 737-2448
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01815443 | Medicaid | NY | |
| 00313539 | Medicaid | NY |
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- Abdul Karim Arida
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All providers in New Hartford, NY · Dental Hygienist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.