Active NPI
Mary Kate Pace, RDH
- Dental Hygienist
- Shalimar, FL
National Provider Identifier
1164037453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH18814
- Practice address
- 1115 N Eglin Pkwy
Shalimar, FL 32579-1228 - Phone
- (850) 651-2199
- NPI assigned
- Sep 13, 2020
- 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 | DH18814 | FL | Primary |
Addresses
Primary practice location
1115 N Eglin Pkwy
Shalimar, FL 32579-1228
Mailing address
2291 Harlan Ave
Fort Walton Beach, FL 32547-7301
Phone (850) 543-5529
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 |
|---|---|---|---|
| DH18814 | FL | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599955200000",
"number": "1164037453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2291 HARLAN AVE",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325477301",
"telephone_number": "850-543-5529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 N EGLIN PKWY",
"city": "SHALIMAR",
"state": "FL",
"postal_code": "325791228",
"telephone_number": "850-651-2199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACE",
"first_name": "MARY",
"middle_name": "KATE",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-13",
"last_updated": "2020-09-13",
"certification_date": "2020-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "FL",
"license": "DH18814",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shalimar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.