Individual provider Active NPI

Kendra Wright

  • Dental Hygienist
  • Willowbrook, IL
National Provider Identifier
1972269967
Registry record updated Nov 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
020014841 Issued in IL
Practice address
6177 Knoll Wood Rd Apt 101
Willowbrook, IL 60527-2079
Phone
(815) 557-0057
NPI assigned
Nov 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2021

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

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 020014841 IL
Community Health Worker 172V00000X 020014841 IL
Health Educator 174H00000X 020014841 IL
Public Health & General Preventive Medicine Physician 2083P0901X 020014841 IL
Home Health Agency 251E00000X 020014841 IL
Public Health or Welfare Agency 251K00000X 020014841 IL
In Home Supportive Care Agency 253Z00000X 020014841 IL
Community Health Clinic/Center 261QC1500X 020014841 IL
Dental Clinic/Center 261QD0000X 020014841 IL
Federally Qualified Health Center (FQHC) 261QF0400X 020014841 IL
Health Service Clinic/Center 261QH0100X 020014841 IL
Federal Public Health Clinic/Center 261QP0904X 020014841 IL
State or Local Public Health Clinic/Center 261QP0905X 020014841 IL
Dental Hygienist 124Q00000X 020014841 IL Primary

Addresses

Primary practice location

6177 Knoll Wood Rd Apt 101
Willowbrook, IL 60527-2079

Mailing address

6177 Knoll Wood Rd Apt 101
Willowbrook, IL 60527-2079
Phone (815) 557-0057

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
020014841ILMDFederal Public Health Clinic/Center

NPI Registry JSON

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

{
    "created_epoch": "1636761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636761600000",
    "number": "1972269967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6177 KNOLL WOOD RD APT 101",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605272079",
            "telephone_number": "815-557-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6177 KNOLL WOOD RD APT 101",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605272079",
            "telephone_number": "815-557-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "KENDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-13",
        "last_updated": "2021-11-13",
        "certification_date": "2021-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "IL",
            "license": "020014841",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "IL",
            "license": "020014841",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "IL",
            "license": "020014841",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "IL",
            "license": "020014841",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "020014841",
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "IL",
            "license": "020014841",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "IL",
            "license": "020014841",
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "IL",
            "license": "020014841",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "020014841",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "IL",
            "license": "020014841",
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "IL",
            "license": "020014841",
            "primary": false
        },
        {
            "code": "261QP0904X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, Federal",
            "state": "IL",
            "license": "020014841",
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "IL",
            "license": "020014841",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "IL",
            "license": "020014841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willowbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2021; 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.