Kids Dental Hygiene, LLC

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

DH000201412 Issued in CO

Legal business name

KIDS DENTAL HYGIENE, LLC

Practice address

28374 County Road 317
Buena Vista, CO 81211-9158

Phone

(719) 395-9048

Fax

(719) 395-9064

NPI assigned

Feb 24, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Donna Jean Boria, RDH

Title

Dental Hygienist

Phone

(719) 221-5273

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424736000000",
    "number": "1831581024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4040",
            "city": "BUENA VISTA",
            "state": "CO",
            "postal_code": "812114040",
            "telephone_number": "719-395-9048",
            "fax_number": "719-395-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28374 COUNTY ROAD 317",
            "city": "BUENA VISTA",
            "state": "CO",
            "postal_code": "812119158",
            "telephone_number": "719-395-9048",
            "fax_number": "719-395-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS DENTAL HYGIENE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-24",
        "last_updated": "2015-02-24",
        "status": "A",
        "authorized_official_last_name": "BORIA",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "DENTAL HYGIENIST",
        "authorized_official_telephone_number": "719-221-5273",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "DH000201412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; 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.