Active NPI
Mary Janell Ontiveros, RDH
- Dental Hygienist
- Jbphh, HI
National Provider Identifier
1144807389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 12090
- Practice address
- 755 Scott Cir
Jbphh, HI 96853-5399 - Phone
- (808) 448-6371
- NPI assigned
- Mar 25, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 12090 | NC | Primary |
Addresses
Primary practice location
755 Scott Cir
Jbphh, HI 96853-5399
Mailing address
755 Scott Cir
Jbphh, HI 96853-5399
Phone (808) 448-6371
Other practice location 1
7223 Mississippi Ave
building # 1561
Fort Polk, LA 71459
Phone (337) 531-4862
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12090 | Other | NC | DENTAL HYGIENIST |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | mary.j.ontiveros.civ@health.mil |
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 |
|---|---|---|---|
| 12090 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690416000000",
"number": "1144807389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 SCOTT CIR",
"city": "JBPHH",
"state": "HI",
"postal_code": "968535399",
"telephone_number": "808-448-6371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 SCOTT CIR",
"city": "JBPHH",
"state": "HI",
"postal_code": "968535399",
"telephone_number": "808-448-6371"
}
],
"practiceLocations": [
{
"address_1": "7223 Mississippi Ave",
"address_2": "building # 1561",
"address_purpose": "LOCATION",
"city": "Fort Polk",
"state": "LA",
"postal_code": "71459",
"country_code": "US",
"telephone_number": "337-531-4862",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ONTIVEROS",
"first_name": "MARY",
"middle_name": "JANELL",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-25",
"last_updated": "2023-07-27",
"certification_date": "2023-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NC",
"license": "12090",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL HYGIENIST",
"identifier": "12090",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "mary.j.ontiveros.civ@health.mil",
"affiliation": "N",
"address_1": "755 Scott Cir",
"city": "Jbphh",
"state": "HI",
"country_code": "US",
"postal_code": "968535399",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Jbphh, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.