NPIMap

Individual provider Active NPI

Lydia Ann Nickerson, RDH

  • Dental Hygienist
  • Bedford, NH
National Provider Identifier
1508243676
Registry record updated Apr 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
01017 Issued in NH
Practice address
4 Bell Hill Rd.
Bedford, NH 03110
Phone
(603) 472-8381
NPI assigned
Apr 28, 2015
Last updated
Apr 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 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 01017 NH Primary

Addresses

Primary practice location

4 Bell Hill Rd.
Bedford, NH 03110

Mailing address

4 Bell Hill Road
Bedford, NH 03110
Phone (603) 472-8381

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
01017NHMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Brandon Beaudoin DMD PLLC PastSince Jan 26, 2022 Accepting new patients
Bedford Village Dental PLLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430179200000",
    "number": "1508243676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BELL HILL ROAD",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "03110",
            "telephone_number": "603-472-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 BELL HILL RD.",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "03110",
            "telephone_number": "603-472-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "LYDIA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-28",
        "last_updated": "2015-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NH",
            "license": "01017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.