Active NPI
Kassandra Hendricks, RDH
- Dental Hygienist
- Kenai, AK
National Provider Identifier
1598501835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 166055
- Practice address
- 508 Upland St
Kenai, AK 99611-8026 - Phone
- (907) 335-7350
- NPI assigned
- Jul 5, 2024
- 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 | 166055 | AK | Primary |
Addresses
Primary practice location
508 Upland St
Kenai, AK 99611-8026
Mailing address
PO Box 3663
Kenai, AK 99611-3663
Phone (907) 252-8245
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 |
|---|---|---|---|
| 166055 | AK | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720137600000",
"number": "1598501835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3663",
"city": "KENAI",
"state": "AK",
"postal_code": "996113663",
"telephone_number": "907-252-8245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 UPLAND ST",
"city": "KENAI",
"state": "AK",
"postal_code": "996118026",
"telephone_number": "907-335-7350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRICKS",
"first_name": "KASSANDRA",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-05",
"last_updated": "2024-07-05",
"certification_date": "2024-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "AK",
"license": "166055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenai, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.