Active NPI
Audrey Cecilia Tejeda, RDH
- Dental Hygienist
- Everett, WA
National Provider Identifier
1235974379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH61577264
- Practice address
- 1424 Broadway
Everett, WA 98201-1720 - Phone
- (425) 789-2000
- NPI assigned
- Jun 29, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH61577264 | WA | Primary |
Addresses
Primary practice location
1424 Broadway
Everett, WA 98201-1720
Mailing address
5831 186TH PL SW Apt C4
Lynnwood, WA 98037-4362
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
| License | State | Type | Specialty |
|---|---|---|---|
| DH61577264 | WA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719619200000",
"number": "1235974379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5831 186TH PL SW APT C4",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980374362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1424 BROADWAY",
"city": "EVERETT",
"state": "WA",
"postal_code": "982011720",
"telephone_number": "425-789-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEJEDA",
"first_name": "AUDREY",
"middle_name": "CECILIA",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-29",
"last_updated": "2024-06-29",
"certification_date": "2024-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WA",
"license": "DH61577264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.