Jacquelyn Fletcher, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

2014016612 Issued in MO

Practice address

530 S Main St
Joplin, MO 64801-2314

Phone

(417) 782-6200

NPI assigned

Mar 24, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1831776145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24200 INFINITY RD",
            "city": "WEBB CITY",
            "state": "MO",
            "postal_code": "648708246",
            "telephone_number": "417-529-8289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S MAIN ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648012314",
            "telephone_number": "417-782-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "JACQUELYN",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MO",
            "license": "2014016612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackson Lawrence Flack
• Leah Flees
• Terence Fleeton II, MAADC II
• Valerie Jane Fleming, NP-C
• Sandi Flesher
• Wilbur Earl Flood, RN, FNP
• Jesus Flores, PTA
• Rico Anthony Mendoza Flosa, MD
• Jodi Flynt
• Cheryl A Fogarty, MD

• All providers in Joplin, MO
• Dental Hygienist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.