Amanda Kilpatrick

Individual provider Active NPI Dental Hygienist · Riley, MI

NPI 1609415595 · NPPES record last updated Dec 25, 2019

Key facts

NPI
1609415595
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
2902016450 (MI)
Practice address
11714 Belle River Rd
Riley, MI 48041-4322
Phone
(313) 260-2601
NPI assigned
Dec 25, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2902016450MIMDDental Hygienist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 2902016450 MI Yes

Addresses

Primary practice location

11714 Belle River Rd
Riley, MI 48041-4322

Mailing address

11714 Belle River Rd
Riley, MI 48041-4322
Phone (313) 260-2601

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL DEARBORN

Other providers in Riley, MI

All providers in Riley, MI · Dental Hygienist in Michigan

Sources for this page

Verify at the official NPI Registry.