Active NPI
Kammi L Grosse, RDH
- Dental Hygienist
- Ava, MO
National Provider Identifier
1548444516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2007028608
- Practice address
- 504 NW 10TH Ave.
Ava, MO 65608 - Phone
- (417) 683-4831
- Fax
- (417) 683-1602
- NPI assigned
- Dec 26, 2007
- Last updated
- Mar 6, 2008
- Sex
- Female
- Sole proprietor
- No
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 | 2007028608 | MO | Primary |
Addresses
Primary practice location
504 NW 10TH Ave.
Ava, MO 65608
Mailing address
PO Box 1359
Ava, MO 65608-1359
Phone (417) 683-4831
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 |
|---|---|---|---|
| 2007028608 | MO | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204761600000",
"number": "1548444516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1359",
"city": "AVA",
"state": "MO",
"postal_code": "656081359",
"telephone_number": "417-683-4831",
"fax_number": "417-683-1602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 NW 10TH AVE.",
"city": "AVA",
"state": "MO",
"postal_code": "65608",
"telephone_number": "417-683-4831",
"fax_number": "417-683-1602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSSE",
"first_name": "KAMMI",
"middle_name": "L",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-26",
"last_updated": "2008-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MO",
"license": "2007028608",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ava, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.