Individual provider Active NPI

Jessica Marie Walker-Livingston, RDH

  • Dental Hygienist
  • Weldon Spring, MO
National Provider Identifier
1932830429
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
2024022321 Issued in MO
Practice address
1030 Wolfrum Rd
Weldon Spring, MO 63304-7795
Phone
(844) 853-8937
NPI assigned
Jun 23, 2022
Last updated
Dec 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
H06118AZMDDental Hygienist
2024022321MOMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Bipar Dental PastSince Jun 1, 2022 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.

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.

Verify at the official NPI Registry.