NICHOLETTE CONGDON (NPI# 1417560608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417560608 |
| Entity Type | Individual |
| Full Name | NICHOLETTE CONGDON |
| Practice Address |
208 E Knoles Drive Flagstaff AZ 86011-0001 |
| Mailing Address |
6369 W Potter Dr Glendale AZ 85308-6606 |
| Practice Telephone | 9285235122 |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2020-08-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | Dental Providers |
| Street Address |
208 E KNOLES DRIVE |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86011-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225558794 | Jeffrey B. Trudo | Specialist/Technologist | 492 East Mcconnell Drive, Flagstaff, AZ 86011 | 2017-06-26 |
| 1376911925 | Np Fromhome, LLC | Nurse Practitioner | 1016 W. University Ave, Suite 206, Flagstaff, AZ 86011 | 2015-09-11 |
| 1902274772 | Staci Mccauley | Specialist/Technologist | 912 Riordan Ranch Rd, Bldg 27a Rm 171, Flagstaff, AZ 86011 | 2015-09-09 |
| 1972118461 | Shanna Rae Begay | Student in an Organized Health Care Education/Training Program | 208 E Pine Knoll Drive Room 215 Building 66, Flagstaff, AZ 86011-0001 | 2020-09-10 |
| 1447863881 | Nina Hoover | Student in an Organized Health Care Education/Training Program | 208 E Pine Knoll Drive, Flagstaff, AZ 86011-0001 | 2020-08-25 |
| 1477028314 | Northern Arizona University | Social Worker | Building 47 A South San Francisco St, Flagstaff, AZ 86011-0001 | 2018-10-08 |
| 1003315110 | Tarang Kumar Jain | Physical Therapist | 208 Pine Knoll Dr Bldg 66, Flagstaff, AZ 86011-0001 | 2018-02-03 |
| 1629581814 | Northern Arizona University | Speech-Language Pathologist | 912 Riordan Rd Bldg 27 A, Flagstaff, AZ 86011-0001 | 2017-11-09 |
| 1659519270 | Kathleen Jodell Ganley | Physical Therapist | 208 Pine Knoll Dr Bldg 66 Rm 103, Flagstaff, AZ 86011-0001 | 2009-02-04 |
| 1235300153 | Emi Isaki | Speech-Language Pathologist | 208 W Pine Knoll Dr, Flagstaff, AZ 86011-0001 | 2008-03-19 |
| Find all providers in zip 86011 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| 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 legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760096085 | Jerry Lee Collins Jr. | Dental Hygienist | 5205 E Cortland Blvd, Flagstaff, AZ 86004-9362 | 2020-09-03 |
| 1093328437 | Ryan M Fisher | Dental Hygienist | 3300 S Gila Dr Apt 1, Flagstaff, AZ 86005-6537 | 2020-08-25 |
| 1043479108 | Fred Summerfelt | Dental Hygienist | 997 E Sterling Ln, Flagstaff, AZ 86001-6572 | 2008-06-04 |
| 1205433646 | Alma Araiza | Dental Hygienist | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2020-10-08 |
| 1124639851 | Cindy Barry | Dental Hygienist | 208 E Pine Knoll Dr, Flagstaff, AZ 86011-0001 | 2020-08-15 |
| 1326671595 | Dana Michelle Morrison | Dental Hygienist | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2020-02-17 |
| 1376033944 | Lydia Louise Cockayne | Dental Hygienist | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2018-05-18 |
| 1407380033 | Shirl Simkins I | Dental Hygienist | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2017-04-20 |
| 1174071047 | Kimberly Scott-freeman | Dental Hygienist | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2016-09-20 |
| 1831647999 | Ryan Wood | Dental Hygienist | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2016-09-19 |
| Find all providers in FLAGSTAFF | ||||
Please comment or provide details below to improve the information on NICHOLETTE CONGDON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.