Amanda Godfrey
Individual provider Active NPI Dental Hygienist · Grimes, IA
NPI 1356107643 · NPPES record last updated Sep 22, 2024
Key facts
- NPI
- 1356107643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- RDH-04217 (IA)
- Practice address
- 348 SE Cedarwood Dr
Grimes, IA 50111-1143 - Phone
- (515) 360-0393
- NPI assigned
- Feb 23, 2024
- 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 |
|---|---|---|---|
| RDH-04217 | IA | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Simply Smiles | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | RDH-04217 | IA | Yes |
Addresses
Primary practice location
348 SE Cedarwood Dr
Grimes, IA 50111-1143
Mailing address
348 SE Cedarwood Dr
Grimes, IA 50111-1143
Phone (515) 360-0393
Other providers in Grimes, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2024. 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.