Active NPI
Jennifer Apocotos-Kirk, RDH,MA
- Dental Hygienist
- Santa Rosa, CA
National Provider Identifier
1316153794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 16784
- Practice address
- 418 Aviation Blvd
Sutie a
Santa Rosa, CA 95403-1074 - Phone
- (707) 575-3105
- NPI assigned
- May 15, 2007
- Last updated
- Feb 24, 2010
- 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 | 16784 | CA | Primary |
Addresses
Primary practice location
418 Aviation Blvd
Sutie a
Santa Rosa, CA 95403-1074
Mailing address
418 Aviation Blvd
Santa Rosa, CA 95403-1074
Phone (707) 575-3105
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16784 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266969600000",
"number": "1316153794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "418 AVIATION BLVD",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954031074",
"telephone_number": "707-575-3105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "418 AVIATION BLVD",
"address_2": "SUTIE A",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954031074",
"telephone_number": "707-575-3105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "APOCOTOS-KIRK",
"first_name": "JENNIFER",
"name_prefix": "Mrs.",
"credential": "RDH,MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2010-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "16784",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.