Kellie C Herbst, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

003847 Issued in MO

Practice address

402 W Jefferson St
Kirksville, MO 63501-3407

Phone

(660) 665-2741

Fax

(660) 665-3109

NPI assigned

Dec 20, 2005

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

Other names 1

• Kellie C Guardado Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1497731574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 CROWN DR",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635012548",
            "telephone_number": "660-627-5757",
            "fax_number": "660-627-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W JEFFERSON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013407",
            "telephone_number": "660-665-2741",
            "fax_number": "660-665-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBST",
        "first_name": "KELLIE",
        "middle_name": "C",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-20",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MO",
            "license": "003847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "GUARDADO",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joseph Hekking
• Mandie Helton
• Heidi B Henderson, RN
• Kristin Nicole Henke, PSYD
• Brandy Marie Pazdernik Hensch
• Timothy M Herbst, DDS
• India Deann Herrmann, PHARM.D.
• Nicholas Joseph Herrmann, PHARMD
• Brandon Herscovitch, PH.D., BCBA-D
• Justin Hicklin, DO

• Dental Hygienist in Kirksville, MO
• Providers in Kirksville, MO by specialty
• Dental Hygienist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.