Individual provider Active NPI

Jennifer Nowotney, RDHAP

  • Dental Hygienist
  • Rancho Cucamonga, CA
National Provider Identifier
1811303357
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
HAP 524 Issued in CA
Practice address
11799 Sebastian Way Ste 103
Rancho Cucamonga, CA 91730-0708
Phone
(909) 268-7922
NPI assigned
Jul 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X HAP 524 CA Primary

Addresses

Primary practice location

11799 Sebastian Way Ste 103
Rancho Cucamonga, CA 91730-0708

Mailing address

11799 Sebastian Way Ste 103
Rancho Cucamonga, CA 91730-0708
Phone (909) 268-7922

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

LicenseStateTypeSpecialty
HAP 524CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
The Friendly Flosser Dental Hygiene Practice of Jennifer Nowotney Dental Hygienist CurrentSince Jun 26, 2022 Accepting new patients

Locations

11799 Sebastian Way
Ste 103
Rancho Cucamonga, CA 91730
Phone (909) 784-5567

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1404432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1811303357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11799 SEBASTIAN WAY STE 103",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300708",
            "telephone_number": "909-268-7922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11799 SEBASTIAN WAY STE 103",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300708",
            "telephone_number": "909-268-7922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWOTNEY",
        "first_name": "JENNIFER",
        "credential": "RDHAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-04",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "HAP 524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.