Jill Marie Kisaka, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

2027 Issued in AK

Practice address

222 Tongass Dr
Attn: Jill Kisaka in Dental
Sitka, AK 99835-9416

Phone

(907) 966-2411

Fax

(907) 966-8663

NPI assigned

Apr 23, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Jill Marie Jacobsen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1366709768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 TONGASS DR",
            "address_2": "ATTN: JILL KISAKA IN DENTAL",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998359416",
            "telephone_number": "907-966-2411",
            "fax_number": "907-966-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 TONGASS DR",
            "address_2": "ATTN: JILL KISAKA IN DENTAL",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998359416",
            "telephone_number": "907-966-2411",
            "fax_number": "907-966-8663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISAKA",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "AK",
            "license": "2027",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "DH 60100153",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "JACOBSEN",
            "middle_name": "MARIE",
            "credential": "RDH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Janelle Marie Kimberlin
• Kaylie Kimberlin
• Carrie Dawn King, RD
• Kim J Kirkness, RN
• John Kirkpatrick, RRT
• Jeannine A Kivisto, RN
• Lindsey Kivisto
• Kevin Knox
• Carole Knuth, PA-C
• Melissa Koenig

• Dental Hygienist in Sitka, AK
• Providers in Sitka, AK by specialty
• Dental Hygienist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; 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.