Lydia Stanley, R.D.H
Individual provider Active NPI Dental Hygienist · Fort.Sill, OK
NPI 1386239002 · NPPES record last updated Feb 10, 2022
Key facts
- NPI
- 1386239002
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 1672 (OK)
- Practice address
- U.S.a Dental Health Actiivity
652 Hamilimton Rd, Headquarters
Fort.Sill, OK 73503 - Phone
- (580) 442-5925
- NPI assigned
- Mar 4, 2021
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1672 | OK | MD | Medical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 1672 | OK | Yes |
Addresses
Primary practice location
U.S.a Dental Health Actiivity
652 Hamilimton Rd, Headquarters
Fort.Sill, OK 73503
Mailing address
U.S.a Dental Health Actiivity
4301 Wilson St , Office Gd152
Fort Sill, OK 73503
Phone (580) 442-5925
Other names
- Lydia Rodriguez
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2022. 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.