Individual provider Active NPI

Megan Nicole Hormann, RDH

  • Dental Hygienist
  • Menifee, CA
National Provider Identifier
1154858496
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
29633 Issued in CA
Practice address
30035 Haun Rd
Menifee, CA 92584-6805
Phone
(951) 225-3324
NPI assigned
May 17, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 29633 CA Primary

Addresses

Primary practice location

30035 Haun Rd
Menifee, CA 92584-6805

Mailing address

30035 Haun Rd
Menifee, CA 92584

Other practice location 1

30291 Hill Ave
Lake Elsinore, CA 92530-3103
Phone (951) 434-2895

Other identifiers 1

IdentifierTypeStateIssuer
29633MedicaidCA

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
29633CAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1154858496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30035 HAUN RD",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "92584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30035 HAUN RD",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925846805",
            "telephone_number": "951-225-3324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30291 Hill Ave",
            "address_purpose": "LOCATION",
            "city": "Lake Elsinore",
            "state": "CA",
            "postal_code": "925303103",
            "country_code": "US",
            "telephone_number": "951-434-2895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORMANN",
        "first_name": "MEGAN",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "29633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29633",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Menifee, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.