Active NPI
Jason Nelson, RDHAP
- Dental Hygienist
- San Bernardino, CA
National Provider Identifier
1407383938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 652
- Practice address
- 939 W 59TH St
San Bernardino, CA 92407-2571 - Phone
- (808) 927-2910
- NPI assigned
- May 15, 2017
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 652 | CA | Primary |
Addresses
Primary practice location
939 W 59TH St
San Bernardino, CA 92407-2571
Mailing address
939 W 59TH St
San Bernardino, CA 92407-2571
Phone (808) 927-2910
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
| License | State | Type | Specialty |
|---|---|---|---|
| 652 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1407383938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "939 W 59TH ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924072571",
"telephone_number": "808-927-2910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "939 W 59TH ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924072571",
"telephone_number": "808-927-2910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "JASON",
"credential": "RDHAP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-05-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dental Hygienist",
"state": "CA",
"license": "652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.