Individual provider Active NPI

Dessie Renee Dixon, RDH

  • Dental Hygienist
  • Davison, MI
National Provider Identifier
1336636166
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
2902013685 Issued in MI
Practice address
9080 Chatwell Club Dr Apt 2
Davison, MI 48423-3010
Phone
(810) 447-6526
NPI assigned
Apr 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 2902013685 MI Primary

Addresses

Primary practice location

9080 Chatwell Club Dr Apt 2
Davison, MI 48423-3010

Mailing address

9080 Chatwell Club Dr Apt 2
Davison, MI 48423-3010
Phone (810) 447-6526

Other names 1

  • Dessie Renee Carradine Former name

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

LicenseStateTypeSpecialty
2902013685MIMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1336636166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9080 CHATWELL CLUB DR APT 2",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484233010",
            "telephone_number": "810-447-6526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9080 CHATWELL CLUB DR APT 2",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484233010",
            "telephone_number": "810-447-6526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "DESSIE",
        "middle_name": "RENEE",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-17",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MI",
            "license": "2902013685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESSIE",
            "last_name": "CARRADINE",
            "middle_name": "RENEE",
            "credential": "RDH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Davison, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.