Individual provider Active NPI

Jessica Garciadeleon, RDH

  • Dental Hygienist
  • Detroit, MI
National Provider Identifier
1417325200
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
2902016254 Issued in MI
Practice address
6550 W Warren Ave
Detroit, MI 48210-1134
Phone
(313) 897-7700
NPI assigned
Sep 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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 2902016254 MI Primary

Addresses

Primary practice location

6550 W Warren Ave
Detroit, MI 48210-1134

Mailing address

18917 Northlawn St
Detroit, MI 48221-2036

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
2902016254MIMDDental Hygienist

Interoperability endpoints

  • Direct secure messaging: jessica.garciadeleon@dchc.directbygreenway.com

NPI Registry JSON

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1417325200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18917 NORTHLAWN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482101134",
            "telephone_number": "313-897-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIADELEON",
        "first_name": "JESSICA",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-10",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MI",
            "license": "2902016254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.