Individual provider Active NPI

Jennifer Burditt, RDH

  • Dental Hygienist
  • Medford, OR
National Provider Identifier
1184888992
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
H5349 Issued in OR
Practice address
3306 S Pacific Hwy
36
Medford, OR 97501-8754
Phone
(503) 758-0689
NPI assigned
Jul 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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 H5349 OR Primary

Addresses

Primary practice location

3306 S Pacific Hwy
36
Medford, OR 97501-8754

Mailing address

3306 S Pacific Hwy Apt 36
Medford, OR 97501-8712
Phone (503) 758-0689

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
H5349ORMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1184888992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3306 S PACIFIC HWY APT 36",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975018712",
            "telephone_number": "503-758-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3306 S PACIFIC HWY",
            "address_2": "36",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975018754",
            "telephone_number": "503-758-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDITT",
        "first_name": "JENNIFER",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-11",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OR",
            "license": "H5349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; 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.