Intrepid Innovations LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

INTREPID INNOVATIONS LLC

Doing business as

Bona Fide Hygiene Care

Practice address

1045 Gateway Loop Ste F
Springfield, OR 97477-1128

Phone

(541) 632-2123

NPI assigned

Oct 18, 2024

Last updated

Oct 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Megan Hanks, EPDHNPI 1639928617

Title

Dental Hygienist

Phone

(919) 592-9591

Specialties & licenses 1

Addresses

Other names 1

• Bona Fide Hygiene Care Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Megan Christine Hanks, RDH, EPP EPDH

  • Dental Hygienist
  • Sprinfield, OR
  • NPI 1639928617
  NPD Authorized official

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729209600000",
    "number": "1659192953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "876 S 69TH PL",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974787315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 GATEWAY LOOP STE F",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974771128",
            "telephone_number": "541-632-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTREPID INNOVATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "HANKS",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "DENTAL HYGIENIST",
        "authorized_official_telephone_number": "919-592-9591",
        "authorized_official_credential": "EPDH"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bona Fide Hygiene Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bobbie Roberta Ingersoll
• Lisa M Ingold, PA-C
• Jennifer Elizabeth Inman, RDH
• Marcia Ann Inman, MA
• Insightful Counseling, LLC (Laurie Cook)
• Barbara K Irving, MD
• Heather Bridgham Ives, DPT
• J Beverly Enterprises, LLC (Remynde Family Health and Wellness)
• Kathleen Anne Jackson, M.D.
• Makia Nicole Jackson, LPN

• Dental Clinic/Center in Springfield, OR
• Providers in Springfield, OR by specialty
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; 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.