Active NPI
Kymberley Beth Dallstream, RDH, BSDH
- Dental Hygienist
- Vernon Hills, IL
National Provider Identifier
1346017902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 020010027
- Practice address
- 270 Center Dr
Vernon Hills, IL 60061-1564 - Phone
- (847) 996-0575
- NPI assigned
- Dec 5, 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 | 020010027 | IL | Primary |
Addresses
Primary practice location
270 Center Dr
Vernon Hills, IL 60061-1564
Mailing address
4933 Darlene Dr
Gurnee, IL 60031-1823
Phone (847) 204-5670
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 |
|---|---|---|---|
| 020010027 | IL | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701734400000",
"number": "1346017902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4933 DARLENE DR",
"city": "GURNEE",
"state": "IL",
"postal_code": "600311823",
"telephone_number": "847-204-5670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "270 CENTER DR",
"city": "VERNON HILLS",
"state": "IL",
"postal_code": "600611564",
"telephone_number": "847-996-0575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALLSTREAM",
"first_name": "KYMBERLEY",
"middle_name": "BETH",
"credential": "RDH, BSDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-12-05",
"last_updated": "2023-12-05",
"certification_date": "2023-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "IL",
"license": "020010027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vernon Hills, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.