Grand Mesa Dental Hygiene, LLC

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

904294 Issued in CO

Legal business name

GRAND MESA DENTAL HYGIENE, LLC

Doing business as

Grand Mesa Dental Hygiene, LLC

Practice address

417 Meeker St
Delta, CO 81416-1918

Phone

(970) 874-3801

Fax

(970) 874-3807

NPI assigned

Jun 13, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Mary P Vigil, RDHNPI 1376618025

Title

Owner

Phone

(970) 874-3801

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grand Mesa Dental Hygiene, LLC 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.

• Mary Powell Vigil, RDH

  • Dental Hygienist
  • Delta, CO
  • NPI 1376618025
  NPD Authorized official

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465776000000",
    "number": "1780034587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 MEEKER ST",
            "city": "DELTA",
            "state": "CO",
            "postal_code": "814161918",
            "telephone_number": "970-874-3801",
            "fax_number": "970-874-3807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 MEEKER ST",
            "city": "DELTA",
            "state": "CO",
            "postal_code": "814161918",
            "telephone_number": "970-874-3801",
            "fax_number": "970-874-3807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND MESA DENTAL HYGIENE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-13",
        "last_updated": "2016-06-13",
        "status": "A",
        "authorized_official_last_name": "VIGIL",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-874-3801",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "904294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49732048",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Mesa Dental Hygiene, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly Leigh Giuliani, DO
• Sara Dawn Gonzalez, APN-C
• Michelle B Gordon, MD
• Kari Graceland Ritter
• Grand Mesa Anesthesia Assoc, Inc
• Grand Valley Wellness, LLC
• Mariah Granzella
• Sharon Gray
• Great Experiences Counseling LLC
• Tamara J Greninger, RN

• Dental Hygienist in Delta, CO
• Providers in Delta, CO by specialty
• Dental Hygienist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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.