Kelli Desouza

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

RDH4221 Issued in ME

Practice address

303 Kimball Pond Rd
New Sharon, ME 04955-3703

Phone

(207) 500-1525

NPI assigned

Mar 18, 2024

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Maine Tiny Dental Eliot LLC

  • Dental Hygienist
  • Eliot, ME
  • NPI 1558249219
  NPD Authorized official
• Maine Tiny Dental LLC

  • Dental Hygienist
  • New Sharon, ME
  • NPI 1124877147
  NPD Authorized official

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1790544914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 KIMBALL POND RD",
            "city": "NEW SHARON",
            "state": "ME",
            "postal_code": "049553703",
            "telephone_number": "207-500-1525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 KIMBALL POND RD",
            "city": "NEW SHARON",
            "state": "ME",
            "postal_code": "049553703",
            "telephone_number": "207-500-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESOUZA",
        "first_name": "KELLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "ME",
            "license": "RDH4221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tarsha L Adams, RN
• Ronda J Avery, RDH, LMT
• Ann Cushing, LADC
• Jamie Cyrus, RDH, IPDH
• Katherine DO
• Nancy German
• Geri Harkins, RDH
• Jessica S Howard, RDH
• Jennifer Knowles

• Dental Hygienist in New Sharon, ME
• Providers in New Sharon, ME by specialty
• Dental Hygienist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.