Individual provider Active NPI

Tracy S Bass, RDH

  • Dental Hygienist
  • Ashburn, GA
National Provider Identifier
1366580888
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH005972 Issued in GA
Practice address
274 Whittle Cir
Ashburn, GA 31714-1918
Phone
(229) 567-4316
Fax
(229) 567-4316
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
DH005972GAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher J. White, DDS, Inc. Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH005972 GA Primary

Addresses

NPPES NPI Registry

Primary practice location

274 Whittle Cir
Ashburn, GA 31714-1918

Mailing address

462 Red Oak Rd
Tifton, GA 31793-5333
Phone (229) 567-4316

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366580888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 RED OAK RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317935333",
            "telephone_number": "229-567-4316",
            "fax_number": "229-567-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 WHITTLE CIR",
            "city": "ASHBURN",
            "state": "GA",
            "postal_code": "317141918",
            "telephone_number": "229-567-4316",
            "fax_number": "229-567-4316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "TRACY",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "GA",
            "license": "DH005972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.