Jessica Beaver, RDH, BS
Individual provider Active NPI Dental Hygienist · Herriman, UT
NPI 1356864516 · NPPES record last updated Jul 19, 2017
Key facts
- NPI
- 1356864516
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 9041914-9920 (UT)
- Practice address
- 13073 S Plum Grove CT
Herriman, UT 84096-5763 - Phone
- (801) 906-1619
- NPI assigned
- Jul 19, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9041914-9920 | UT | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 9041914-9920 | UT | Yes |
Addresses
Primary practice location
13073 S Plum Grove CT
Herriman, UT 84096-5763
Mailing address
13073 S Plum Grove CT
Herriman, UT 84096-5763
Phone (801) 906-1619
Other providers in Herriman, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2017. 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.