Active NPI
Lydia Jardine, RDH
- Dental Hygienist
- Alameda, CA
National Provider Identifier
1104915305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- RDH 20602
- Practice address
- Building One
Uscg Coast Guard Island
Alameda, CA 94501 - Phone
- (510) 437-3615
- NPI assigned
- Oct 12, 2006
- 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 | RDH 20602 | CA | Primary |
Addresses
Primary practice location
Building One
Uscg Coast Guard Island
Alameda, CA 94501
Mailing address
930 Prospect Ave
Vallejo, CA 94592-1168
Phone (510) 437-3615
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 |
|---|---|---|---|
| RDH 20602 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104915305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "930 PROSPECT AVE",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945921168",
"telephone_number": "510-437-3615",
"fax_number": "510-437-3034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BUILDING ONE",
"address_2": "USCG COAST GUARD ISLAND",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "94501",
"telephone_number": "510-437-3615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JARDINE",
"first_name": "LYDIA",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "RDH 20602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alameda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.