Individual provider Active NPI

Jamie Jividen, RDH

  • Dental Hygienist
  • Smethport, PA
National Provider Identifier
1912875543
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH068273 Issued in PA
Practice address
619 Irish Holw
Smethport, PA 16749-4115
Phone
(814) 596-3172
NPI assigned
Oct 27, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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 DH068273 PA Primary

Addresses

Primary practice location

619 Irish Holw
Smethport, PA 16749-4115

Mailing address

619 Irish Holw
Smethport, PA 16749-4115

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
DH068273PAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1761523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1912875543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 IRISH HOLW",
            "city": "SMETHPORT",
            "state": "PA",
            "postal_code": "167494115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 IRISH HOLW",
            "city": "SMETHPORT",
            "state": "PA",
            "postal_code": "167494115",
            "telephone_number": "814-596-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIVIDEN",
        "first_name": "JAMIE",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-27",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "PA",
            "license": "DH068273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smethport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; 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.