Mackenzie Jean Blackwell, RDH
Individual provider Active NPI Dental Hygienist · South Hill, VA
NPI 1821576901 · NPPES record last updated Aug 1, 2018
Key facts
- NPI
- 1821576901
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 0402207558 (VA)
- Practice address
- 604 N. Thomas St
South Hill, VA 23970 - Phone
- (434) 447-4464
- NPI assigned
- Aug 1, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0402207558 | VA | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 0402207558 | VA | Yes |
Addresses
Primary practice location
604 N. Thomas St
South Hill, VA 23970
Mailing address
P.O. Box 599
604 N. Thomas St
South Hill, VA 23970
Phone (434) 447-4464
Other providers in South Hill, VA
- Bebold Recovery LLC
- Janet Lee Biancardi
- Victoria Simmons Bishop
- Teri Ann Bistarkey
- Eric Blackwell
- Bailey Lynn Bowen
- Elizabeth Yancey Bowlin
- Bernita Danica Boyd
- Tina Louise Bracey
- George Breedlove
All providers in South Hill, VA · Dental Hygienist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.