Mia R Fairley, DENTAL HYGIENIST

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

DH00007998 Issued in WA

Practice address

4406 Kubota LN
Pasco, WA 99301-9561

Phone

(509) 727-3535

NPI assigned

Jan 30, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1738195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1720891880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4406 KUBOTA LN",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993019561",
            "telephone_number": "509-727-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4406 KUBOTA LN",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993019561",
            "telephone_number": "509-727-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRLEY",
        "first_name": "MIA",
        "middle_name": "R",
        "credential": "DENTAL HYGIENIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "DH00007998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Hygienist in Pasco, WA
• Providers in Pasco, WA by specialty
• Dental Hygienist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.