Active NPI
Carrie Arvonda Secrist Simpler, RDH
- Dental Hygienist
- Denton, MD
National Provider Identifier
1720615487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 5857
- Practice address
- 808 S 5TH Ave
Denton, MD 21629-1398 - Phone
- (410) 479-2650
- Fax
- (410) 479-1626
- NPI assigned
- Mar 24, 2020
- 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 | 5857 | MD | Primary |
Addresses
Primary practice location
808 S 5TH Ave
Denton, MD 21629-1398
Mailing address
301 Randolph St
Denton, MD 21629-1243
Phone (410) 479-4306
Other names 1
- Carrie Secrist
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5857 | MD | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585094400000",
"number": "1720615487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 RANDOLPH ST",
"city": "DENTON",
"state": "MD",
"postal_code": "216291243",
"telephone_number": "410-479-4306",
"fax_number": "410-479-1714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "808 S 5TH AVE",
"city": "DENTON",
"state": "MD",
"postal_code": "216291398",
"telephone_number": "410-479-2650",
"fax_number": "410-479-1626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SECRIST SIMPLER",
"first_name": "CARRIE",
"middle_name": "ARVONDA",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-24",
"last_updated": "2020-03-25",
"certification_date": "2020-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MD",
"license": "5857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CARRIE",
"last_name": "SECRIST",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Denton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.