Individual provider Active NPI

Julie C Vanderkroef, RDH

  • Dental Hygienist
  • Wallingford, CT
National Provider Identifier
1609170273
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
003881 Issued in CT
Practice address
85 Barnes Rd
Suite 207
Wallingford, CT 06492-1832
Phone
(203) 678-1201
Fax
(203) 678-1209
NPI assigned
Dec 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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 003881 CT Primary

Addresses

Primary practice location

85 Barnes Rd
Suite 207
Wallingford, CT 06492-1832

Mailing address

888 Worcester St
Suite 130
Wellesley, MA 02482-3744
Phone (617) 964-6681

Other names 1

  • Julie C Lichty Former name

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
003881CTMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1292976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1609170273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 WORCESTER ST",
            "address_2": "SUITE 130",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024823744",
            "telephone_number": "617-964-6681",
            "fax_number": "339-686-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 BARNES RD",
            "address_2": "SUITE 207",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064921832",
            "telephone_number": "203-678-1201",
            "fax_number": "203-678-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERKROEF",
        "first_name": "JULIE",
        "middle_name": "C",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-22",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CT",
            "license": "003881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "LICHTY",
            "middle_name": "C",
            "credential": "RDH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.