Stephanie Andreya Jackson in Provo - Dental Hygienist
Stephanie Andreya Jackson - NPI 1205045796
Stephanie Andreya Jackson is a Dental Hygienist in Provo, Utah. Stephanie Andreya Jackson practices all healthcare services and medical treatments related to Dental Hygienist. The NPI Number for Stephanie Andreya Jackson is 1205045796. The last update date is 2007-07-08.
Stephanie Andreya Jackson's current location address is 801 Crestview Ave, Provo, Utah. You can contact this provider via phone number 8012229354. The mailing address for Stephanie Andreya Jackson is 801 Crestview Ave, Provo, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stephanie Andreya Jackson |
|---|---|
| Address | 801 Crestview Ave, Provo, Utah |
| Phone Number | 8012229354 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | RDH |
NPI Number Detail
| NPI Number | 1205045796 |
|---|---|
| Provider Enumeration Date | 2007-05-21 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 801 Crestview Ave |
|---|---|
| City | Provo |
| State | Utah (UT) |
| Post Code | 846044777 |
| Phone Number | 8012229354 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dental Hygienist |
|---|---|
| Taxonomy | 124Q00000X |
| Licence No | 13208 |
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Definition: An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be |
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What is the unique identification code assigned to Stephanie Andreya Jackson by the Centers for Medicare & Medicaid Services?
The Stephanie Andreya Jackson has been issued the NPI (National Provider Identifier) 1205045796. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Stephanie Andreya Jackson is located?
The Stephanie Andreya Jackson is situated at the following address: 801 Crestview Ave, Provo, UT, 846044777.
What is Stephanie Andreya Jackson's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Stephanie Andreya Jackson is Dental Hygienist, and the taxonomy classification code that categorizes this area of expertise is 124Q00000X.
On what date was the 1205045796 assigned to Stephanie Andreya Jackson?
The Stephanie Andreya Jackson was issued its 1205045796 on 2007-05-21, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Stephanie Andreya Jackson most recently updated or revised?
The information pertaining to Stephanie Andreya Jackson, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.