Active NPI
Kelli Ann Beckman
- Dental Hygienist
- Port Orchard, WA
National Provider Identifier
1104437565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 60172005
- Practice address
- 1141 Beach Dr E
Port Orchard, WA 98366-4937 - Phone
- (206) 745-3808
- NPI assigned
- Aug 11, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 60172005 | WA | Primary |
Addresses
Primary practice location
1141 Beach Dr E
Port Orchard, WA 98366-4937
Mailing address
PO Box 46
Keyport, WA 98345-0046
Phone (206) 745-3808
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 |
|---|---|---|---|
| 60172005 | WA | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sarah Luetke, PLLC | Dental Hygienist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597104000000",
"number": "1104437565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 46",
"city": "KEYPORT",
"state": "WA",
"postal_code": "983450046",
"telephone_number": "206-745-3808",
"fax_number": "206-745-3811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1141 BEACH DR E",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983664937",
"telephone_number": "206-745-3808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKMAN",
"first_name": "KELLI",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-11",
"last_updated": "2020-08-11",
"certification_date": "2020-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WA",
"license": "60172005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Orchard, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.