Active NPI
Janet Marie Conklin, RDH
- Dental Hygienist
- Meriden, CT
National Provider Identifier
1609980945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 004244
- Practice address
- 1 Prestige Dr
Suite #107
Meriden, CT 06450-7164 - Phone
- (203) 639-0311
- Fax
- (203) 639-7873
- NPI assigned
- Aug 17, 2006
- 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 | 004244 | CT | Primary |
Addresses
Primary practice location
1 Prestige Dr
Suite #107
Meriden, CT 06450-7164
Mailing address
25 Needham St
Newton, MA 02461-1615
Phone (617) 964-6681
Other names 1
- Janet Marie Nicholas
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 |
|---|---|---|---|
| 004244 | CT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609980945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 NEEDHAM ST",
"city": "NEWTON",
"state": "MA",
"postal_code": "024611615",
"telephone_number": "617-964-6681",
"fax_number": "617-630-0141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PRESTIGE DR",
"address_2": "SUITE #107",
"city": "MERIDEN",
"state": "CT",
"postal_code": "064507164",
"telephone_number": "203-639-0311",
"fax_number": "203-639-7873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONKLIN",
"first_name": "JANET",
"middle_name": "MARIE",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CT",
"license": "004244",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JANET",
"last_name": "NICHOLAS",
"middle_name": "MARIE",
"code": "1",
"type": "Former Name"
}
]
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Sources for this page
- 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.