Clarina P Petrovich, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

DH.002025196 Issued in CO

Practice address

23205 Bay Oaks Ave
Parker, CO 80138-5742

Phone

(808) 352-9132

NPI assigned

Jun 15, 2015

Last updated

Jan 13, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ohana Mobile Dental Hygiene

  • Dental Hygienist
  • Parker, CO
  • NPI 1639820863
  NPD

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1336520329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23205 BAY OAKS AVE",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801385742",
            "telephone_number": "808-352-9132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23205 BAY OAKS AVE",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801385742",
            "telephone_number": "808-352-9132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROVICH",
        "first_name": "CLARINA",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-15",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "HI",
            "license": "1696",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "VA",
            "license": "0402203045",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "DH.002025196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lee Peterson, FNP-C
• Rebekah Lynn Petkoff, FNP-BC
• Morgan Petrangelo
• Michael Petrie, LMT
• Lilit Petrosian
• Elizabeth Petrucelli, CCCE
• Robert Pettas, DPT
• Allison L Pfauth, PT, DPT
• Kailey Phelan
• Kimberly R Phelps, PT

• Dental Hygienist in Parker, CO
• Providers in Parker, CO by specialty
• Dental Hygienist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.