Peggy Sue Kenyon, RDH
Individual provider Active NPI Dental Hygienist · Ft Warren Afb, WY
NPI 1316084239 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1316084239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 633 (WY)
- Practice address
- 6900 Alden Dr
Ft Warren Afb, WY 82005-3906 - Phone
- (307) 773-1846
- Fax
- (307) 773-3550
- NPI assigned
- Jan 31, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 633 | WY | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 633 | WY | Yes |
Addresses
Primary practice location
6900 Alden Dr
Ft Warren Afb, WY 82005-3906
Mailing address
6900 Alden Dr
Ft Warren Afb, WY 82005-3906
Phone (307) 773-1846
Other providers in Ft Warren Afb, WY
- Matt James Cowan
- Teddy Lynn Ellis
- Brian Patrick Hayes
- James Louis Kretzschmar
- Perala Enterprises, LLC
All providers in Ft Warren Afb, WY · Dental Hygienist in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.