Individual provider Active NPI

Eileen L Hartman, RDH

  • Dental Hygienist
  • Ft Gordon, GA
National Provider Identifier
1114020492
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
2555 Issued in SC
Practice address
38TH Street/BLDG 38717
USA Dentac
Ft Gordon, GA 30905-5660
Phone
(706) 787-6927
Fax
(706) 787-2082
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 5604-016 WI
Dental Hygienist 124Q00000X 2555 SC Primary

Addresses

Primary practice location

38TH Street/BLDG 38717
USA Dentac
Ft Gordon, GA 30905-5660

Mailing address

38TH Street/BLDG 38717
USA Dentac
Ft Gordon, GA 30905-5660
Phone (706) 787-6927

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

LicenseStateTypeSpecialty
5604-016WIMDDental Hygienist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1114020492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38TH STREET/BLDG 38717",
            "address_2": "USA DENTAC",
            "city": "FT GORDON",
            "state": "GA",
            "postal_code": "309055660",
            "telephone_number": "706-787-6927",
            "fax_number": "706-787-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38TH STREET/BLDG 38717",
            "address_2": "USA DENTAC",
            "city": "FT GORDON",
            "state": "GA",
            "postal_code": "309055660",
            "telephone_number": "706-787-6927",
            "fax_number": "706-787-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "EILEEN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WI",
            "license": "5604-016",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "SC",
            "license": "2555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Gordon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.