Individual provider Active NPI

Debra A Viger, RDH, BHS, PHDH, FADH

  • Dental Hygienist
  • Crystal Lake, IL
National Provider Identifier
1407671399
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
020-006103 Issued in IL
Practice address
1395 Candlewood Dr
Crystal Lake, IL 60014-8960
Phone
(815) 236-9092
NPI assigned
Nov 18, 2024
Last updated
Nov 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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 020-006103 IL Primary

Addresses

Primary practice location

1395 Candlewood Dr
Crystal Lake, IL 60014-8960

Mailing address

1395 Candlewood Dr
Crystal Lake, IL 60014-8960
Phone (815) 236-9092

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
020-006103ILMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1407671399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 CANDLEWOOD DR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600148960",
            "telephone_number": "815-236-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 CANDLEWOOD DR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600148960",
            "telephone_number": "815-236-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGER",
        "first_name": "DEBRA",
        "middle_name": "A",
        "credential": "RDH, BHS, PHDH, FADH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "IL",
            "license": "020-006103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.