Active NPI
Connie Lynn Welden, RDH
- Dental Hygienist
- Irmo, SC
National Provider Identifier
1861669145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 5605
- Practice address
- 318 Ridge Run TRL
Irmo, SC 29063-8667 - Phone
- (803) 732-5808
- NPI assigned
- May 14, 2008
- 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 | 5605 | GA | Primary |
Addresses
Primary practice location
318 Ridge Run TRL
Irmo, SC 29063-8667
Mailing address
318 Ridge Run TRL
Irmo, SC 29063-8667
Phone (803) 732-5808
Other names 1
- Miss Connie Lynn Lattner
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 |
|---|---|---|---|
| 5605 | GA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210723200000",
"number": "1861669145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "318 RIDGE RUN TRL",
"city": "IRMO",
"state": "SC",
"postal_code": "290638667",
"telephone_number": "803-732-5808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "318 RIDGE RUN TRL",
"city": "IRMO",
"state": "SC",
"postal_code": "290638667",
"telephone_number": "803-732-5808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELDEN",
"first_name": "CONNIE",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-14",
"last_updated": "2008-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "GA",
"license": "5605",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CONNIE",
"last_name": "LATTNER",
"middle_name": "LYNN",
"prefix": "MISS",
"credential": "RDH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Irmo, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.