Active NPI
Jessica Marie Walker-Livingston, RDH
- Dental Hygienist
- Weldon Spring, MO
National Provider Identifier
1932830429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2024022321
- Practice address
- 1030 Wolfrum Rd
Weldon Spring, MO 63304-7795 - Phone
- (844) 853-8937
- NPI assigned
- Jun 23, 2022
- Last updated
- Dec 23, 2024
- 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 | H06118 | AZ | |
| Dental Hygienist | 124Q00000X | 2024022321 | MO | Primary |
Addresses
Primary practice location
1030 Wolfrum Rd
Weldon Spring, MO 63304-7795
Mailing address
3028 E Marconi Ave
Phoenix, AZ 85032-3735
Other practice location 1
9610 N Metro Pkwy W
Phoenix, AZ 85051-1402
Phone (877) 809-5092
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 |
|---|---|---|---|
| H06118 | AZ | MD | Dental Hygienist |
| 2024022321 | MO | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bipar Dental | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dental Clinic/Center
- Phoenix, AZ
- NPI 1528993318
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734912000000",
"number": "1932830429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3028 E MARCONI AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850323735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 WOLFRUM RD",
"city": "WELDON SPRING",
"state": "MO",
"postal_code": "633047795",
"telephone_number": "844-853-8937"
}
],
"practiceLocations": [
{
"address_1": "9610 N Metro Pkwy W",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850511402",
"country_code": "US",
"telephone_number": "877-809-5092",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALKER-LIVINGSTON",
"first_name": "JESSICA",
"middle_name": "MARIE",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-23",
"last_updated": "2024-12-23",
"certification_date": "2024-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "AZ",
"license": "H06118",
"primary": false
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MO",
"license": "2024022321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Weldon Spring, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.