Individual provider Active NPI

Stephanie L Gatlin, RDH

  • Dental Hygienist
  • Grand Junction, CO
National Provider Identifier
1407453517
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
904701 Issued in CO
Practice address
2333 N 6TH St
Grand Junction, CO 81501-2001
Phone
(970) 200-1600
NPI assigned
Oct 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 904701 CO Primary

Addresses

Primary practice location

2333 N 6TH St
Grand Junction, CO 81501-2001

Mailing address

847 Jasper Dr
Fruita, CO 81521-8313
Phone (970) 221-1273

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
904701COMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1407453517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 JASPER DR",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815218313",
            "telephone_number": "970-221-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 N 6TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012001",
            "telephone_number": "970-200-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATLIN",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "904701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; 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.