Individual provider Active NPI

Jaime Dahl

  • Dental Hygienist
  • Guerneville, CA
National Provider Identifier
1497563480
Registry record updated Dec 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
23924 Issued in CA
Practice address
16387 First St FL 3
Guerneville, CA 95446-8817
Phone
(707) 869-2933
NPI assigned
Dec 21, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 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 23924 CA Primary

Addresses

Primary practice location

16387 First St FL 3
Guerneville, CA 95446-8817

Mailing address

656 Sparkes Rd
Sebastopol, CA 95472-5043
Phone (707) 484-9339

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
23924CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1734739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734739200000",
    "number": "1497563480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 SPARKES RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954725043",
            "telephone_number": "707-484-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16387 FIRST ST FL 3",
            "city": "GUERNEVILLE",
            "state": "CA",
            "postal_code": "954468817",
            "telephone_number": "707-869-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHL",
        "first_name": "JAIME",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-21",
        "last_updated": "2024-12-21",
        "certification_date": "2024-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "23924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guerneville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.