Individual provider Active NPI

Erica Lynn Jones Hindbaugh, DDS

  • Dentist
  • Arcata, CA
National Provider Identifier
1700219128
Registry record updated Aug 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
54573 Issued in CA
Practice address
4602 Valley West Blvd
Arcata, CA 95521-4636
Phone
(707) 822-4689
Fax
(707) 822-1400
NPI assigned
Aug 21, 2013
Last updated
Aug 21, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 54573 CA Primary

Addresses

Primary practice location

4602 Valley West Blvd
Arcata, CA 95521-4636

Mailing address

4602 Valley West Blvd
Arcata, CA 95521-4636
Phone (707) 822-4689

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160811001469 CA Order and Referring Only - Other (Non-Physician) 7618261744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377043200000",
    "number": "1700219128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 VALLEY WEST BLVD",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955214636",
            "telephone_number": "707-822-4689",
            "fax_number": "707-822-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 VALLEY WEST BLVD",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955214636",
            "telephone_number": "707-822-4689",
            "fax_number": "707-822-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES HINDBAUGH",
        "first_name": "ERICA",
        "middle_name": "LYNN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-21",
        "last_updated": "2013-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcata, CA

Sources for this page

Verify at the official NPI Registry.