Crystal Michelle Jarvis, RDH

Individual provider Active NPI Dental Hygienist · Whiteman Afb, MO

NPI 1316199748 · NPPES record last updated Oct 16, 2008

Key facts

NPI
1316199748
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
20398 (FL)
Practice address
331 Sijan Ave
509TH Medical Group/SGD
Whiteman Afb, MO 65305-5001
Phone
(660) 687-2201
Fax
(660) 687-4376
NPI assigned
Oct 16, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
20398FLMDDental Hygienist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 20398 FL Yes

Addresses

Primary practice location

331 Sijan Ave
509TH Medical Group/SGD
Whiteman Afb, MO 65305-5001

Mailing address

331 Sijan Ave
509 Medical Group/SGD
Whiteman Afb, MO 65305-5001

Other providers in Whiteman Afb, MO

All providers in Whiteman Afb, MO · Dental Hygienist in Missouri

Sources for this page

Verify at the official NPI Registry.