Active NPI
Kerri Holen Willert, RDH
- Dental Hygienist
- Albuquerque, NM
National Provider Identifier
1265026256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH5192
- Practice address
- 8400 Osuna Rd NE Ste 1a
Albuquerque, NM 87111-2068 - Phone
- (505) 275-0500
- NPI assigned
- Feb 22, 2021
- 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 | DH5192 | NM | Primary |
Addresses
Primary practice location
8400 Osuna Rd NE Ste 1a
Albuquerque, NM 87111-2068
Mailing address
8813 Avenales Ave NE
Albuquerque, NM 87111-2314
Phone (303) 596-1093
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 |
|---|---|---|---|
| DH5192 | NM | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613952000000",
"number": "1265026256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8813 AVENALES AVE NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871112314",
"telephone_number": "303-596-1093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8400 OSUNA RD NE STE 1A",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871112068",
"telephone_number": "505-275-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLERT",
"first_name": "KERRI",
"middle_name": "HOLEN",
"name_prefix": "Mrs.",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-22",
"last_updated": "2021-02-22",
"certification_date": "2021-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NM",
"license": "DH5192",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.