Active NPI
Rosetta Loper, CRDH
- Dental Hygienist
- Travis Afb, CA
National Provider Identifier
1891490918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH22364
- Practice address
- 136 Cannon Dr
Travis Afb, CA 94535-1132 - Phone
- (210) 428-9752
- NPI assigned
- Mar 31, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH22364 | FL | Primary |
| Military Health Care Provider | 171000000X |
Addresses
Primary practice location
136 Cannon Dr
Travis Afb, CA 94535-1132
Mailing address
David Grant Medical Center
151 Bodin Circle
Fairfield, CA 94535
Phone (707) 423-7000
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 |
|---|---|---|---|
| DH22364 | FL | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680220800000",
"number": "1891490918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DAVID GRANT MEDICAL CENTER",
"address_2": "151 BODIN CIRCLE",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "94535",
"telephone_number": "707-423-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 CANNON DR",
"city": "TRAVIS AFB",
"state": "CA",
"postal_code": "945351132",
"telephone_number": "210-428-9752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPER",
"first_name": "ROSETTA",
"credential": "CRDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-31",
"last_updated": "2023-03-31",
"certification_date": "2023-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "FL",
"license": "DH22364",
"primary": true
},
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Travis Afb, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.