Individual provider Active NPI

Vicki Gae Nelson, R.D.H.

  • Dental Hygienist
  • Bainbridge Island, WA
National Provider Identifier
1912289364
Registry record updated Sep 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH00001057 Issued in WA
Practice address
221 Winslow Way W Ste 302
Bainbridge Island, WA 98110-4917
Phone
(206) 909-1365
NPI assigned
Sep 12, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH00001057 WA Primary

Addresses

Primary practice location

221 Winslow Way W Ste 302
Bainbridge Island, WA 98110-4917

Mailing address

24105 184TH Ave SE
Covington, WA 98042-4896
Phone (425) 433-6221

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

LicenseStateTypeSpecialty
DH00001057WAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Washington State Smile Partners Past Accepting new patients
Washington State Smile Partners Dental Hygienist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315785600000",
    "number": "1912289364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24105 184TH AVE SE",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980424896",
            "telephone_number": "425-433-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 WINSLOW WAY W STE 302",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981104917",
            "telephone_number": "206-909-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "VICKI",
        "middle_name": "GAE",
        "name_prefix": "Mrs.",
        "credential": "R.D.H.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-12",
        "last_updated": "2011-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "DH00001057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; 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.