Sparkling Smiles Mobile Dentistry LLC

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

Legal business name

SPARKLING SMILES MOBILE DENTISTRY LLC

Practice address

6671 US Hwy 36
Joes, CO 80822

Phone

(970) 630-4226

NPI assigned

Nov 9, 2020

Last updated

Nov 20, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kassidee N FickenNPI 1194326900

Title

RDH

Phone

(970) 630-4226

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kassidee N Ficken, RDH

  • Dental Hygienist
  • Joes, CO
  • NPI 1194326900
  NPD Authorized official

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605830400000",
    "number": "1235730953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7525 COUNTY ROAD M",
            "city": "KIRK",
            "state": "CO",
            "postal_code": "808249759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6671 US HWY 36",
            "city": "JOES",
            "state": "CO",
            "postal_code": "80822",
            "telephone_number": "970-630-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKLING SMILES MOBILE DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "FICKEN",
        "authorized_official_first_name": "KASSIDEE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "RDH",
        "authorized_official_telephone_number": "970-630-4226"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kassidee N Ficken, RDH
• Traci Simon, RDH

• Dental Hygienist in Joes, CO
• Providers in Joes, CO by specialty
• Dental Hygienist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.