Charlea Dawn Deroche, R.D.H.

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

DEN-RDH-LIC-21507 Issued in MT

Practice address

830 W Central Ave
Missoula, MT 59801-7931

Phone

(406) 829-9515

Fax

(406) 829-9519

NPI assigned

Nov 16, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: charlea.deroche@allnations.directbygreenway.com

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1124737424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 W CENTRAL AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598017931",
            "telephone_number": "406-829-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 W CENTRAL AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598017931",
            "telephone_number": "406-829-9515",
            "fax_number": "406-829-9519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROCHE",
        "first_name": "CHARLEA",
        "middle_name": "DAWN",
        "credential": "R.D.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MT",
            "license": "DEN-RDH-LIC-21507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry A Dent, PHARM.D.
• Dental Care of Montana, LLC
• Nicole Victoria Dente, RDN
• Matea Michelle Depoe, M.S, LAT, ATC
• Alyssa Derby
• Aaron J Derry, PAC
• Kelsey Rebecca Deschamps, PHARMD
• Kelsie Deshner, BCBA
• Desmet School District
• Desmet School District

• Dental Hygienist in Missoula, MT
• Providers in Missoula, MT by specialty
• Dental Hygienist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.