Active NPI
Keisha Denise Parks, RDH
- Dental Hygienist
- Detroit, MI
National Provider Identifier
1932502077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2902015144
- Practice address
- 5379 Crane St
Detroit, MI 48213-2918 - Phone
- (313) 405-8972
- NPI assigned
- Oct 3, 2014
- Last updated
- Oct 3, 2014
- 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 | 2902015144 | MI | Primary |
Addresses
Primary practice location
5379 Crane St
Detroit, MI 48213-2918
Mailing address
5379 Crane St
Detroit, MI 48213-2918
Phone (313) 405-8972
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 |
|---|---|---|---|
| 2902015144 | MI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412294400000",
"number": "1932502077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5379 CRANE ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482132918",
"telephone_number": "313-405-8972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5379 CRANE ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482132918",
"telephone_number": "313-405-8972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKS",
"first_name": "KEISHA",
"middle_name": "DENISE",
"name_prefix": "Mrs.",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-03",
"last_updated": "2014-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MI",
"license": "2902015144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.