Active NPI
Heather Danelle Blair
- Dental Hygienist
- Rocky Ford, CO
National Provider Identifier
1508450685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 905876
- Practice address
- 903 S 12TH St
Rocky Ford, CO 81067-2127 - Phone
- (719) 254-7623
- NPI assigned
- Mar 1, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 905876 | CO | Primary |
Addresses
Primary practice location
903 S 12TH St
Rocky Ford, CO 81067-2127
Mailing address
903 S 12TH St
Rocky Ford, CO 81067-2127
Phone (719) 254-7623
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 905876 | Other | CO | LICENSURE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 905876 | CO | MD | Dental Hygienist |
Interoperability endpoints
- heather.vigil.p1@direct.vwhs.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614556800000",
"number": "1508450685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "903 S 12TH ST",
"city": "ROCKY FORD",
"state": "CO",
"postal_code": "810672127",
"telephone_number": "719-254-7623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "903 S 12TH ST",
"city": "ROCKY FORD",
"state": "CO",
"postal_code": "810672127",
"telephone_number": "719-254-7623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAIR",
"first_name": "HEATHER",
"middle_name": "DANELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-01",
"last_updated": "2021-03-01",
"certification_date": "2021-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CO",
"license": "905876",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSURE",
"identifier": "905876",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rocky Ford, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.