Individual provider Active NPI

Kory Nieuwkoop, BS, RDH, RDHAP

  • Dental Hygienist
  • Chowchilla, CA
National Provider Identifier
1720532450
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
684 Issued in CA
Practice address
23171 Road 7
Chowchilla, CA 93610-9204
Phone
(559) 706-8741
NPI assigned
Aug 11, 2016
Last updated
Nov 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 30113 CA
Dental Hygienist 124Q00000X DH-3275 ID
Dental Hygienist 124Q00000X 684 CA Primary

Addresses

Primary practice location

23171 Road 7
Chowchilla, CA 93610-9204

Mailing address

23171 Road 7
Chowchilla, CA 93610-9204
Phone (559) 706-8741

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
30113CAMDDental Hygienist
DH-3275IDMDDental Hygienist
684CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1720532450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23171 ROAD 7",
            "city": "CHOWCHILLA",
            "state": "CA",
            "postal_code": "936109204",
            "telephone_number": "559-706-8741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23171 ROAD 7",
            "city": "CHOWCHILLA",
            "state": "CA",
            "postal_code": "936109204",
            "telephone_number": "559-706-8741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEUWKOOP",
        "first_name": "KORY",
        "credential": "BS, RDH, RDHAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-11",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "30113",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "ID",
            "license": "DH-3275",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chowchilla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.

Verify at the official NPI Registry.