Individual provider Active NPI

Kathleen Lachcik

  • Dental Hygienist
  • Daytona Beach, FL
National Provider Identifier
1295478048
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH29388 Issued in FL
Practice address
1845 Holsonback Dr
Daytona Beach, FL 32117-5114
Phone
(407) 430-5455
NPI assigned
Apr 19, 2022
Last updated
Apr 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH29388 FL Primary

Addresses

Primary practice location

1845 Holsonback Dr
Daytona Beach, FL 32117-5114

Mailing address

1470 Clearwater CT
Lake Mary, FL 32746-5200
Phone (407) 430-5455

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

LicenseStateTypeSpecialty
DH29388FLMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1295478048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470 CLEARWATER CT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465200",
            "telephone_number": "407-430-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 HOLSONBACK DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175114",
            "telephone_number": "407-430-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACHCIK",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "FL",
            "license": "DH29388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.