Kristy Lynn Derosia, R.D.H

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

H4727 Issued in MN

Practice address

1420 London Rd
Suite 206
Duluth, MN 55805-2433

Phone

(218) 481-7474

Fax

(218) 789-4150

NPI assigned

Aug 29, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1851640478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 LONDON RD",
            "address_2": "SUITE 206",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052433",
            "telephone_number": "218-481-7474",
            "fax_number": "218-789-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 LONDON RD",
            "address_2": "SUITE 206",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052433",
            "telephone_number": "218-481-7474",
            "fax_number": "218-789-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSIA",
        "first_name": "KRISTY",
        "middle_name": "LYNN",
        "credential": "R.D.H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MN",
            "license": "H4727",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WI",
            "license": "10916-016",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Charlotte Depenthal
• Bruce James Derauf
• Derin J Van Loon OD PA
• Dermatology Duluth LLC
• Dale Edward Derocher, MS
• Cathy Jo Derosier, RN
• Constance Jeanne Derungs
• Christine Helen Desjardins, PHARMD
• Kirsten Lee Desmarais, PT
• Christa H Deters, OTR

• Dental Hygienist in Duluth, MN
• Providers in Duluth, MN by specialty
• Dental Hygienist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.