Active NPI
Amanda Harvey, RDH
- Dental Hygienist
- Jacksonville, FL
National Provider Identifier
1275908865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 0402206767
- Practice address
- 554 Keily Street
Bureau of Medicine & Surgery - Credentials and Privileg
Jacksonville, FL 32212 - Phone
- (757) 953-7011
- NPI assigned
- Dec 8, 2015
- 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 | 0402206767 | VA | Primary |
Addresses
Primary practice location
554 Keily Street
Bureau of Medicine & Surgery - Credentials and Privileg
Jacksonville, FL 32212
Mailing address
554 Keily Street
Bureau of Medicine & Surgery - Credentials and Privileg
Jacksonville, FL 32212
Phone (757) 953-7011
Other names 1
- Amanda Rochelle Ralph
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 |
|---|---|---|---|
| 0402206767 | VA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449532800000",
"number": "1275908865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "554 KEILY STREET",
"address_2": "BUREAU OF MEDICINE & SURGERY - CREDENTIALS AND PRIVILEG",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32212",
"telephone_number": "757-953-7011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "554 KEILY STREET",
"address_2": "BUREAU OF MEDICINE & SURGERY - CREDENTIALS AND PRIVILEG",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32212",
"telephone_number": "757-953-7011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARVEY",
"first_name": "AMANDA",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-08",
"last_updated": "2015-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "VA",
"license": "0402206767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "RALPH",
"middle_name": "ROCHELLE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.