Active NPI
Brittany Queen, RDH
- Dental Hygienist
- Pilot Knob, MO
National Provider Identifier
1407509482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2016015092
- Practice address
- 315 W Mulberry Ste B
Pilot Knob, MO 63663-7860 - Phone
- (573) 546-1001
- Fax
- (573) 546-1002
- NPI assigned
- Jan 31, 2022
- Sex
- Female
- Sole proprietor
- No
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 | 2016015092 | MO | Primary |
Addresses
Primary practice location
315 W Mulberry Ste B
Pilot Knob, MO 63663-7860
Mailing address
110 S 2ND St
Ellington, MO 63638-9400
Phone (573) 663-2313
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 |
|---|---|---|---|
| 2016015092 | MO | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643587200000",
"number": "1407509482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 S 2ND ST",
"city": "ELLINGTON",
"state": "MO",
"postal_code": "636389400",
"telephone_number": "573-663-2313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 W MULBERRY STE B",
"city": "PILOT KNOB",
"state": "MO",
"postal_code": "636637860",
"telephone_number": "573-546-1001",
"fax_number": "573-546-1002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUEEN",
"first_name": "BRITTANY",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-31",
"last_updated": "2022-01-31",
"certification_date": "2022-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MO",
"license": "2016015092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pilot Knob, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.