Connie Keiser, RDH
Individual provider Active NPI Dental Hygienist · Center, CO
NPI 1124297510 · NPPES record last updated Feb 29, 2008
Key facts
- NPI
- 1124297510
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 904401 (CO)
- Practice address
- 220 S Worth Street
Center, CO 81125 - Phone
- (719) 754-3584
- Fax
- (719) 754-2470
- NPI assigned
- Feb 29, 2008
- 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 |
|---|---|---|---|
| 904401 | CO | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 904401 | CO | Yes |
Addresses
Primary practice location
220 S Worth Street
Center, CO 81125
Mailing address
128 Market St
Alamosa, CO 81101-2290
Phone (719) 589-5161
Other providers in Center, CO
- Isaiah Lee Archuleta
- Miranda Asbell
- Center Consolidated School District 2654
- Alejandra Garcia
- Denise I Lobato
- San Luis Valley Community Mental Health Center
- San Luis Valley Community Mental Health Center
- San Luis Valley Community Mental Health Center
- San Luis Valley Community Mental Health Center, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 29, 2008. 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.