Active NPI
Wendylynn Marie Clark, RDH
- Dental Hygienist
- Kaneohe, HI
National Provider Identifier
1881942811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH1225
- Practice address
- BLDG 3089D Street MCBH
21St Dental Company
Kaneohe, HI 96863 - Phone
- (808) 257-3100
- NPI assigned
- Aug 23, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | DH1225 | HI | Primary |
Addresses
Primary practice location
BLDG 3089D Street MCBH
21St Dental Company
Kaneohe, HI 96863
Mailing address
PO Box 63037
21St Dental MCBH
MCBH Kaneohe Bay, HI 96863-3037
Phone (808) 257-3100
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 |
|---|---|---|---|
| DH1225 | HI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346025600000",
"number": "1881942811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 63037",
"address_2": "21ST DENTAL MCBH",
"city": "MCBH KANEOHE BAY",
"state": "HI",
"postal_code": "968633037",
"telephone_number": "808-257-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BLDG 3089D STREET MCBH",
"address_2": "21ST DENTAL COMPANY",
"city": "KANEOHE",
"state": "HI",
"postal_code": "96863",
"telephone_number": "808-257-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "WENDYLYNN",
"middle_name": "MARIE",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-23",
"last_updated": "2012-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "HI",
"license": "DH1225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kaneohe, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.