Active NPI
Traci Simon, RDH
- Dental Hygienist
- Joes, CO
National Provider Identifier
1174990931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 002024015
- Practice address
- 6671 US 36
Joes, CO 80822-2321 - Phone
- (719) 343-5152
- NPI assigned
- Aug 27, 2015
- Last updated
- Feb 22, 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 | 002024015 | CO | Primary |
Addresses
Primary practice location
6671 US 36
Joes, CO 80822-2321
Mailing address
PO Box 115
Stratton, CO 80836-0115
Phone (308) 233-7008
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 |
|---|---|---|---|
| 002024015 | CO | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613952000000",
"number": "1174990931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 115",
"city": "STRATTON",
"state": "CO",
"postal_code": "808360115",
"telephone_number": "308-233-7008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6671 US 36",
"city": "JOES",
"state": "CO",
"postal_code": "808222321",
"telephone_number": "719-343-5152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "TRACI",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-27",
"last_updated": "2021-02-22",
"certification_date": "2021-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CO",
"license": "002024015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joes, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.