Active NPI
Kaitlyn April Ornelas
- Dental Hygienist
- Lake Havasu City, AZ
National Provider Identifier
1649765868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- Practice address
- 228 London Bridge Rd
Lake Havasu City, AZ 86403-4685 - Phone
- (928) 854-0300
- NPI assigned
- Jun 29, 2018
- 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 | Primary |
Addresses
Primary practice location
228 London Bridge Rd
Lake Havasu City, AZ 86403-4685
Mailing address
1850 Willow Ave
Lake Havasu City, AZ 86403-5631
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39900047318171 | Medicaid | AZ |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530230400000",
"number": "1649765868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1850 WILLOW AVE",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864035631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "228 LONDON BRIDGE RD",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864034685",
"telephone_number": "928-854-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORNELAS",
"first_name": "KAITLYN",
"middle_name": "APRIL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-29",
"last_updated": "2018-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39900047318171",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Havasu City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.