Active NPI
Katrina Lynn Vance, DENTAL HYGIENIST
- Dental Hygienist
- Camp Lejeune, NC
National Provider Identifier
1104592740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 11081
- Practice address
- 2D Denben/NDC, PSC 20130
315 McHugh Blvd.
Camp Lejeune, NC 28542 - Phone
- (910) 451-2208
- NPI assigned
- Aug 23, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 11081 | NC | Primary |
Addresses
Primary practice location
2D Denben/NDC, PSC 20130
315 McHugh Blvd.
Camp Lejeune, NC 28542
Mailing address
2D Denben/NDC, PSC 20130
315 McHugh Blvd.
Camp Lejeune, NC 28542
Phone (910) 451-2208
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 |
|---|---|---|---|
| 11081 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629676800000",
"number": "1104592740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2D DENBEN/NDC, PSC 20130",
"address_2": "315 MCHUGH BLVD.",
"city": "CAMP LEJEUNE",
"state": "NC",
"postal_code": "28542",
"telephone_number": "910-451-2208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2D DENBEN/NDC, PSC 20130",
"address_2": "315 MCHUGH BLVD.",
"city": "CAMP LEJEUNE",
"state": "NC",
"postal_code": "28542",
"telephone_number": "910-451-2208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANCE",
"first_name": "KATRINA",
"middle_name": "LYNN",
"credential": "DENTAL HYGIENIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-23",
"last_updated": "2021-08-23",
"certification_date": "2021-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NC",
"license": "11081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camp Lejeune, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.