Active NPI
Taylor Danielle Ewert
- Dental Hygienist
- Blue Jay, CA
National Provider Identifier
1851050652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- RDH32204
- Practice address
- 27201 Ca-189
Blue Jay, CA 92317 - Phone
- (909) 337-6670
- NPI assigned
- Dec 9, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | RDH32204 | CA | Primary |
Addresses
Primary practice location
27201 Ca-189
Blue Jay, CA 92317
Mailing address
PO Box 3364
Crestline, CA 92325-3364
Phone (951) 660-3265
Other practice location 1
29099 Hospital Rd
200
Lake Arrowhead, CA 92352
Phone (909) 336-4045
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 |
|---|---|---|---|
| RDH32204 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639008000000",
"number": "1851050652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3364",
"city": "CRESTLINE",
"state": "CA",
"postal_code": "923253364",
"telephone_number": "951-660-3265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27201 CA-189",
"city": "BLUE JAY",
"state": "CA",
"postal_code": "92317",
"telephone_number": "909-337-6670"
}
],
"practiceLocations": [
{
"address_1": "29099 Hospital Rd",
"address_2": "200",
"address_purpose": "LOCATION",
"city": "Lake Arrowhead",
"state": "CA",
"postal_code": "92352",
"country_code": "US",
"telephone_number": "909-336-4045",
"fax_number": "909-336-4505",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EWERT",
"first_name": "TAYLOR",
"middle_name": "DANIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-09",
"last_updated": "2021-12-09",
"certification_date": "2021-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "RDH32204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blue Jay, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.