Individual provider Active NPI

Tabitha Vollmer, RDH

  • Dental Hygienist
  • Springfield, MO
National Provider Identifier
1639618325
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
2012022466 Issued in MO
Practice address
1701 W. Sunshine Street
Suite Q
Springfield, MO 65807-2261
Phone
(417) 501-1048
Fax
(417) 501-1661
NPI assigned
Feb 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X 2016004424 MO
Dental Hygienist 124Q00000X 2012022466 MO Primary
Dental Assistant 126800000X 2016004425 MO
Dental Assistant 126800000X 2016004427 MO
Dental Assistant 126800000X 2016004422 MO

Addresses

Primary practice location

1701 W. Sunshine Street
Suite Q
Springfield, MO 65807-2261

Mailing address

1701 W Sunshine
Suite Q
Springfield, MO 65807-2261
Phone (417) 501-1048

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
2012022466MOMDDental Hygienist
2016004422MOMDDental Assistant
2016004424MOMDDental Assistant
2016004425MOMDDental Assistant
2016004427MOMDDental Assistant

NPI Registry JSON

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1639618325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W SUNSHINE",
            "address_2": "SUITE Q",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658072261",
            "telephone_number": "417-501-1048",
            "fax_number": "417-501-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W. SUNSHINE STREET",
            "address_2": "SUITE Q",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658072261",
            "telephone_number": "417-501-1048",
            "fax_number": "417-501-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLLMER",
        "first_name": "TABITHA",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "MO",
            "license": "2016004424",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MO",
            "license": "2012022466",
            "primary": true
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "MO",
            "license": "2016004425",
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "MO",
            "license": "2016004427",
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "MO",
            "license": "2016004422",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; 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.