Active NPI
Jessica Himalstein
- Dental Hygienist
- Fort Myers, FL
National Provider Identifier
1811421720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH23934
- Practice address
- 4447 Camino Real Way
Fort Myers, FL 33966-1019 - Phone
- (239) 980-0667
- NPI assigned
- Apr 18, 2017
- Last updated
- Apr 18, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| DH002024605 | CO | MD | Dental Hygienist |
| DH23934 | FL | MD | Dental 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.