Individual provider Active NPI

Jessica Porazinski McMullin, RDH, MPH

  • Dental Hygienist
  • Hartford, CT
National Provider Identifier
1508268798
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
006570 Issued in CT
Practice address
960 Main Street
Health Services, 9TH Floor
Hartford, CT 06103-1225
Phone
(860) 882-8714
NPI assigned
Sep 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

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 006570 CT Primary

Addresses

Primary practice location

960 Main Street
Health Services, 9TH Floor
Hartford, CT 06103-1225

Mailing address

358 Middletown Ave
Wethersfield, CT 06109-3806
Phone (860) 436-3076

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
006570CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411084800000",
    "number": "1508268798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 MIDDLETOWN AVE",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061093806",
            "telephone_number": "860-436-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 MAIN STREET",
            "address_2": "HEALTH SERVICES, 9TH FLOOR",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061031225",
            "telephone_number": "860-882-8714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLIN",
        "first_name": "JESSICA",
        "middle_name": "PORAZINSKI",
        "name_prefix": "Mrs.",
        "credential": "RDH, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-19",
        "last_updated": "2014-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CT",
            "license": "006570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; 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.