Individual provider Active NPI

Melissa Kincaid, RDH

  • Dental Hygienist
  • Bristol, FL
National Provider Identifier
1174940308
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH19851 Issued in FL
Practice address
12832 NW Central Ave
Liberty County Health Department
Bristol, FL 32321-6918
Phone
(850) 643-2292
NPI assigned
Mar 26, 2014
Last updated
Mar 26, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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 DH19851 FL Primary

Addresses

Primary practice location

12832 NW Central Ave
Liberty County Health Department
Bristol, FL 32321-6918

Mailing address

12832 NW Central Ave
Liberty County Health Department
Bristol, FL 32321-6918
Phone (850) 643-2292

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
DH19851FLMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1174940308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12832 NW CENTRAL AVE",
            "address_2": "LIBERTY COUNTY HEALTH DEPARTMENT",
            "city": "BRISTOL",
            "state": "FL",
            "postal_code": "323216918",
            "telephone_number": "850-643-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12832 NW CENTRAL AVE",
            "address_2": "LIBERTY COUNTY HEALTH DEPARTMENT",
            "city": "BRISTOL",
            "state": "FL",
            "postal_code": "323216918",
            "telephone_number": "850-643-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCAID",
        "first_name": "MELISSA",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-26",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "FL",
            "license": "DH19851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; 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.