Caitlin Jane Parker, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

12242994-9923 Issued in UT

Practice address

U.S. Naval Hospital Guam
BLDG 50, Farenholt Avenue
Agana Heights, GU 96910

Phone

(671) 344-9340

NPI assigned

May 19, 2021

Last updated

Oct 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1497329817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "U.S. NAVAL HOSPITAL GUAM",
            "address_2": "PSC 455 BOX 208",
            "city": "FPO",
            "state": "AP",
            "postal_code": "96540",
            "telephone_number": "671-344-9340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "U.S. NAVAL HOSPITAL GUAM",
            "address_2": "BLDG 50, FARENHOLT AVENUE",
            "city": "AGANA HEIGHTS",
            "state": "GU",
            "postal_code": "96910",
            "telephone_number": "671-344-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "CAITLIN",
        "middle_name": "JANE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "12242994-9923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Victoria Nebzydoski
• NH Guam (Dod Naval Hospital Guam Pharmacy)
• NH Guam
• NH Guam
• Nathaniel R Novak
• Mario Fernando Pereyra, MOTR/L
• Vanessa Perez, RN
• Carl Powell, PHARMD
• Nina Radcliffe, FNP-BC
• Melissa Rivera, PHD

• Dentist in Agana Heights, GU
• Providers in Agana Heights, GU by specialty
• Dentist in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.