Active NPI
Jody Haberman, RDH
- Dental Hygienist
- Ellensburg, WA
National Provider Identifier
1316631492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH60301774
- Practice address
- 4081 Riverbottom Rd
Ellensburg, WA 98926-8931 - Phone
- (509) 929-4184
- NPI assigned
- Jun 2, 2023
- 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 | DH60301774 | WA | Primary |
Addresses
Primary practice location
4081 Riverbottom Rd
Ellensburg, WA 98926-8931
Mailing address
4081 Riverbottom Rd
Ellensburg, WA 98926-8931
Phone (509) 929-4184
Other practice location 1
3090 Smithson Rd
Ellensburg, WA 98926-8889
Phone (509) 929-4184
Other practice location 2
2401 W Dolarway Rd
Ellensburg, WA 98926-9309
Phone (509) 929-4184
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Hanson.jody@hotmail.com | Direct |
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 |
|---|---|---|---|
| DH60301774 | WA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685664000000",
"number": "1316631492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4081 RIVERBOTTOM RD",
"city": "ELLENSBURG",
"state": "WA",
"postal_code": "989268931",
"telephone_number": "509-929-4184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4081 RIVERBOTTOM RD",
"city": "ELLENSBURG",
"state": "WA",
"postal_code": "989268931",
"telephone_number": "509-929-4184"
}
],
"practiceLocations": [
{
"address_1": "3090 Smithson Rd",
"address_purpose": "LOCATION",
"city": "Ellensburg",
"state": "WA",
"postal_code": "989268889",
"country_code": "US",
"telephone_number": "509-929-4184",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2401 W Dolarway Rd",
"address_purpose": "LOCATION",
"city": "Ellensburg",
"state": "WA",
"postal_code": "989269309",
"country_code": "US",
"telephone_number": "509-929-4184",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HABERMAN",
"first_name": "JODY",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-02",
"last_updated": "2023-06-02",
"certification_date": "2021-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WA",
"license": "DH60301774",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Hanson.jody@hotmail.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "4081 Riverbottom Rd",
"city": "Ellensburg",
"state": "WA",
"country_code": "US",
"postal_code": "989268931",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Ellensburg, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.