Staci A Bermudez, RDH
Individual provider Active NPI Dental Hygienist · Poulsbo, WA
NPI 1346895869 · NPPES record last updated Aug 2, 2019
Key facts
- NPI
- 1346895869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- HL60609954 (WA)
- Practice address
- 2235 NE Castle Dr
Poulsbo, WA 98370-8068 - Phone
- (206) 745-3808
- Fax
- (206) 745-3811
- NPI assigned
- Aug 2, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HL60609954 | WA | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sarah Luetke, PLLC | Dental Hygienist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | HL60609954 | WA | Yes |
Addresses
Primary practice location
2235 NE Castle Dr
Poulsbo, WA 98370-8068
Mailing address
3377 Bethel Rd SE # 107-155
Port Orchard, WA 98366-5608
Phone (360) 602-9493
Other providers in Poulsbo, WA
- Kirk Bellon
- Sophie Bells
- Betty A Bennett
- Julie Bennett
- Craig A Benson
- Lisa Bernardin
- Best Day Wellness PLLC
- Best Dental Help
- Robert V Bethel
- Heather Biermann
All providers in Poulsbo, WA · Dental Hygienist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.