Active NPI
Johana L Medina
- Dental Hygienist
- Aspen, CO
National Provider Identifier
1265127922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 002024469
- Practice address
- 0405 Castle Creek Rd
Aspen, CO 81611 - Phone
- (970) 929-5420
- NPI assigned
- Apr 10, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | 002024469 | CO | Primary |
Addresses
Primary practice location
0405 Castle Creek Rd
Aspen, CO 81611
Mailing address
345 Columbine Dr
Rifle, CO 81650-9353
Phone (970) 274-1146
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 |
|---|---|---|---|
| 002024469 | CO | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681084800000",
"number": "1265127922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 COLUMBINE DR",
"city": "RIFLE",
"state": "CO",
"postal_code": "816509353",
"telephone_number": "970-274-1146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "0405 CASTLE CREEK RD",
"city": "ASPEN",
"state": "CO",
"postal_code": "81611",
"telephone_number": "970-929-5420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "JOHANA",
"middle_name": "L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-04-10",
"last_updated": "2023-04-10",
"certification_date": "2023-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CO",
"license": "002024469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aspen, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.