Active NPI
Edilyn Gurion, RDH
- Dental Hygienist
- Vallejo, CA
National Provider Identifier
1619321353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 26650
- Practice address
- 2920 Sonoma Blvd
#A
Vallejo, CA 94590-3875 - Phone
- (707) 558-2000
- Fax
- (707) 644-3507
- NPI assigned
- Apr 19, 2016
- 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 | 26650 | CA | Primary |
Addresses
Primary practice location
2920 Sonoma Blvd
#A
Vallejo, CA 94590-3875
Mailing address
2920 Sonoma Blvd
#A
Vallejo, CA 94590-3875
Phone (707) 558-2000
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 |
|---|---|---|---|
| 26650 | CA | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Clinica de la Raza Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba La Clinica Vallejo Dental
- Dental Clinic/Center
- Vallejo, CA
- NPI 1780606632
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461024000000",
"number": "1619321353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2920 SONOMA BLVD",
"address_2": "#A",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945903875",
"telephone_number": "707-558-2000",
"fax_number": "707-644-3507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2920 SONOMA BLVD",
"address_2": "#A",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945903875",
"telephone_number": "707-558-2000",
"fax_number": "707-644-3507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GURION",
"first_name": "EDILYN",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-19",
"last_updated": "2016-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "26650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.