Active NPI
Kristin Michelle Patrick, RDH
- Dental Hygienist
- Indianapolis, IN
National Provider Identifier
1790238541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 13007081A
- Practice address
- 3403 E Raymond St
Indianapolis, IN 46203-4744 - Phone
- (317) 957-2100
- NPI assigned
- Jul 28, 2016
- 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 | 13007081A | IN | Primary |
Addresses
Primary practice location
3403 E Raymond St
Indianapolis, IN 46203-4744
Mailing address
3403 E Raymond St
Indianapolis, IN 46203-4744
Phone (317) 957-2100
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 |
|---|---|---|---|
| 13007081A | IN | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469664000000",
"number": "1790238541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3403 E RAYMOND ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462034744",
"telephone_number": "317-957-2100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3403 E RAYMOND ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462034744",
"telephone_number": "317-957-2100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRICK",
"first_name": "KRISTIN",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-28",
"last_updated": "2016-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "IN",
"license": "13007081A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.