Individual provider Active NPI

Jasmine Wyatt Griechen, RDH

  • Dental Hygienist
  • Belton, MO
National Provider Identifier
1376720581
Registry record updated Jun 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
RDH22749 Issued in CA
Practice address
802 E Walnut St
Belton, MO 64012-2544
Phone
(816) 322-7600
Fax
(816) 322-7606
NPI assigned
Jan 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X RDH22749 CA Primary
Dental Hygienist 124Q00000X 2009024711 MO

Addresses

Primary practice location

802 E Walnut St
Belton, MO 64012-2544

Mailing address

710 SW Misty GLN
Grain Valley, MO 64029-2500
Phone (816) 322-7600

Other identifiers 2

IdentifierTypeStateIssuer
1477563518MedicaidCA
FHC70081FMedicaidCA

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
RDH22749CAMDDental Hygienist
2009024711MOMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1376720581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 SW MISTY GLN",
            "city": "GRAIN VALLEY",
            "state": "MO",
            "postal_code": "640292500",
            "telephone_number": "816-322-7600",
            "fax_number": "816-322-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 E WALNUT ST",
            "city": "BELTON",
            "state": "MO",
            "postal_code": "640122544",
            "telephone_number": "816-322-7600",
            "fax_number": "816-322-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIECHEN",
        "first_name": "JASMINE",
        "middle_name": "WYATT",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-30",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "RDH22749",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MO",
            "license": "2009024711",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477563518",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70081F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; 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.