Kelly M Winchester Povar, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

5228 Issued in AZ

Practice address

2487 S Gilbert Rd Ste 105
Gilbert, AZ 85296-5802

Phone

(480) 732-1888

Fax

(480) 732-1890

NPI assigned

Mar 15, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kelly M Provar Other 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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528192390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2487 S GILBERT RD STE 105",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852965802",
            "telephone_number": "480-732-1888",
            "fax_number": "480-732-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2487 S GILBERT RD STE 105",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852965802",
            "telephone_number": "480-732-1888",
            "fax_number": "480-732-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINCHESTER POVAR",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "AZ",
            "license": "5228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "PROVAR",
            "middle_name": "M",
            "credential": "RDH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Dental Hygienist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Dental Hygienist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.