Individual provider Active NPI

Guofang Fan, RDH

  • Dental Hygienist
  • Yakima, WA
National Provider Identifier
1184853327
Registry record updated Jul 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH00007046 Issued in WA
Practice address
221 Saint Andrews PL
Yakima, WA 98908-9317
Phone
(509) 972-1613
NPI assigned
Jul 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2009

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 DH00007046 WA Primary

Addresses

Primary practice location

221 Saint Andrews PL
Yakima, WA 98908-9317

Mailing address

221 Saint Andrews PL
Yakima, WA 98908-9317
Phone (509) 972-1613

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
DH00007046WAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247097600000",
    "number": "1184853327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 SAINT ANDREWS PL",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989089317",
            "telephone_number": "509-972-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 SAINT ANDREWS PL",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989089317",
            "telephone_number": "509-972-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "GUOFANG",
        "name_prefix": "Ms.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-09",
        "last_updated": "2009-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "DH00007046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; 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.