Individual provider Active NPI

Debra Ann Kolden, RDH

  • Dental Hygienist
  • Grand Forks Afb, ND
National Provider Identifier
1215077458
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
H7364 Issued in MN
Practice address
1599 J St BLDG 109
Grand Forks Afb, ND 58205-6306
Phone
(701) 747-5393
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 H7364 MN Primary

Addresses

Primary practice location

1599 J St BLDG 109
Grand Forks Afb, ND 58205-6306

Mailing address

815 Duke Dr Apt 236
Grand Forks, ND 58201-3987
Phone (701) 330-1212

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
H7364MNMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215077458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 DUKE DR APT 236",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013987",
            "telephone_number": "701-330-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 J ST BLDG 109",
            "city": "GRAND FORKS AFB",
            "state": "ND",
            "postal_code": "582056306",
            "telephone_number": "701-747-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLDEN",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MN",
            "license": "H7364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks Afb, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.