Individual provider Active NPI

Glenda Ann Reed-Withers, RDH

  • Dental Hygienist
  • Fort Stewart, GA
National Provider Identifier
1205289865
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH009363 Issued in GA
Practice address
343 Warrior Road Building 2115
Fort Stewart, GA 31315
Phone
(912) 767-7841
NPI assigned
Jul 19, 2016
Last updated
Jul 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 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 DH009363 GA Primary

Addresses

Primary practice location

343 Warrior Road Building 2115
Fort Stewart, GA 31315

Mailing address

1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (912) 767-7841

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
DH009363GAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1205289865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-767-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 WARRIOR ROAD BUILDING 2115",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "31315",
            "telephone_number": "912-767-7841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED-WITHERS",
        "first_name": "GLENDA",
        "middle_name": "ANN",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "GA",
            "license": "DH009363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Stewart, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.