Jenna Lynn Sicard, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

015.0134280 Issued in VT

Practice address

52 Gelo Park Rd
Lowell, VT 05847-9796

Phone

(802) 744-6641

NPI assigned

Jul 17, 2023

Last updated

Jul 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1932888948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3465 LAKE ROAD",
            "city": "NEWPORT CENTER",
            "state": "VT",
            "postal_code": "05857",
            "telephone_number": "802-673-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 GELO PARK RD",
            "city": "LOWELL",
            "state": "VT",
            "postal_code": "058479796",
            "telephone_number": "802-744-6641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Railroad St",
            "address_purpose": "LOCATION",
            "city": "Island Pond",
            "state": "VT",
            "postal_code": "058469405",
            "country_code": "US",
            "telephone_number": "802-723-4373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SICARD",
        "first_name": "JENNA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "VT",
            "license": "015.0134280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sam Corbo
• Mia Camille Hartman
• Cynthia Warren Taska, M.S.W.

• Dental Hygienist in Lowell, VT
• Providers in Lowell, VT by specialty
• Dental Hygienist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.