Tina Renae McCaffrie, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

7892 Issued in GA

Practice address

8828 Jayden LN NE
Lacey, WA 98516-8200

Phone

(706) 615-6670

NPI assigned

Sep 18, 2019

Last updated

Sep 18, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Tina Renae Gann Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1245880590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8828 JAYDEN LN NE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985168200",
            "telephone_number": "706-615-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8828 JAYDEN LN NE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985168200",
            "telephone_number": "706-615-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAFFRIE",
        "first_name": "TINA",
        "middle_name": "RENAE",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-18",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "SC",
            "license": "10829",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "GA",
            "license": "7892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "GANN",
            "middle_name": "RENAE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dental Hygienist in Lacey, WA
• Providers in Lacey, WA by specialty
• Dental Hygienist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; 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.