Jennifer Camille Vollstedt, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

DH60250684 Issued in WA

Practice address

2403 N 3Rd St
Washougal, WA 98671-8517

Phone

(503) 816-7067

NPI assigned

Dec 27, 2011

Last updated

Dec 27, 2011By the provider in NPPES

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

• Jennifer Camille Bush 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": "1324944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324944000000",
    "number": "1407125073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 N 3RD ST",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "986718517",
            "telephone_number": "503-816-7067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 N 3RD ST",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "986718517",
            "telephone_number": "503-816-7067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLLSTEDT",
        "first_name": "JENNIFER",
        "middle_name": "CAMILLE",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-27",
        "last_updated": "2011-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "DH60250684",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OR",
            "license": "H6179",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BUSH",
            "middle_name": "CAMILLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Teilissa L Tua, DPT
• Treena Naomi Turner
• Julius Urbanavicius, PHARMD
• Annie Vo, PHARMD
• Hannah Josephine Vogel, MA
• Chih Wang
• Washougal Acupuncture and Massage, LLC (Washougal Acupuncture and Massage)
• Washougal Assisted Living, LLC (Columbia Ridge Assisted Living, LLC)
• Washougal Chiropractic Center, Inc
• Washougal Family Medicine, PS (Washougal Family Medicine)

• Dental Hygienist in Washougal, WA
• Providers in Washougal, WA by specialty
• Dental Hygienist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.