Jacqueline Ann Koon, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

12188 Issued in TX

Practice address

6050 Long Prairie Rd
Suite 100
Flower Mound, TX 75028-2294

Phone

(972) 316-6320

NPI assigned

Mar 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427189455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2671 CREEKSIDE WAY",
            "city": "HIGHLAND VILLAGE",
            "state": "TX",
            "postal_code": "750778622",
            "telephone_number": "214-636-7045",
            "fax_number": "214-636-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6050 LONG PRAIRIE RD",
            "address_2": "SUITE 100",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282294",
            "telephone_number": "972-316-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOON",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "TX",
            "license": "12188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Hygienist in Flower Mound, TX
• Providers in Flower Mound, TX by specialty
• Dental Hygienist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.