Individual provider Active NPI

Jessica Himalstein

  • Dental Hygienist
  • Fort Myers, FL
National Provider Identifier
1811421720
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH23934 Issued in FL
Practice address
4447 Camino Real Way
Fort Myers, FL 33966-1019
Phone
(239) 980-0667
NPI assigned
Apr 18, 2017
Last updated
Apr 18, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH002024605 CO
Dental Hygienist 124Q00000X DH23934 FL Primary

Addresses

Primary practice location

4447 Camino Real Way
Fort Myers, FL 33966-1019

Mailing address

6171 Island Park CT
Fort Myers, FL 33908-4626
Phone (239) 980-0667

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
DH002024605COMDDental Hygienist
DH23934FLMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1811421720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6171 ISLAND PARK CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084626",
            "telephone_number": "239-980-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4447 CAMINO REAL WAY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661019",
            "telephone_number": "239-980-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIMALSTEIN",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "DH002024605",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "FL",
            "license": "DH23934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.