KATHLEEN WILLIS-FARMER (NPI# 1578054367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578054367 |
| Entity Type | Individual |
| Full Name | KATHLEEN WILLIS-FARMER |
| Credential | RDH |
| Practice Address |
10590 Enduring Freedom Drive Fort Drum NY 13602 |
| Mailing Address |
10590 Enduring Freedom Drive Fort Drum NY 13602-5005 |
| Practice Telephone | 3157726234 |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2018-06-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 19916 | CA | Dental Providers |
| N | 124Q00000X | Dental Hygienist | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MILITARY BASE | 19916 | 01 |
| Street Address |
10590 ENDURING FREEDOM DRIVE |
| City | FORT DRUM |
| State | NY |
| Zip Code | 13602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720078983 | Donald Foster | Dentist | 10590 Enduring Freedom Drive, Us Army Dental Activity, Fort Drum, NY 13602-5005 | 2005-10-27 |
| 1881103521 | Elizabeth Haley Fowler | Dental Hygienist | 10590 Enduring Freedom Drive, Us Army Dental Activity, Fort Drum, NY 13602-5005 | 2017-09-26 |
| 1366967663 | Kaleigh Marie Namiotka | Dentist | 10590 Enduring Freedom Drive, Fort Drum, NY 13602 | 2017-08-08 |
| 1952856114 | Jane Bowers | Dental Hygienist | 10590 Enduring Freedom Drive, Fort Drum, NY 13602-5005 | 2016-08-17 |
| 1497152409 | Spencer Joseph | Dentist | 10590 Enduring Freedom Drive, Fort Drum, NY 13602 | 2014-11-20 |
| 1942606983 | Adam Schwarzberg | Dentist | 10590 Enduring Freedom Drive, Fort Drum, NY 13602 | 2014-11-18 |
| 1285030775 | Kyle Libby | Dentist | 10590 Enduring Freedom Drive, Fort Drum, NY 13602-5005 | 2014-11-10 |
| 1356778500 | Aubrey Russell Hopkins | Dentist | 10590 Enduring Freedom Drive, Fort Drum, NY 13602-5005 | 2013-10-02 |
| 1689006025 | Diondre Lamar Venable | Dentist | 10590 Enduring Freedom Drive, Fort Drum, NY 13602 | 2013-08-08 |
| 1912230913 | Jorge Eller Valdes | Dentist | 10590 Enduring Freedom Drive, Us Army Dental Hqs Ft Drum, Fort Drum, NY 13602-5005 | 2009-09-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235697590 | Joshua Lee Hickman | Physician Assistant | Bldg P10506 Euphrates River Valley Rd, Fort Drum, NY 13602 | 2019-03-06 |
| 1447721345 | Lisa Marie Lewis | Social Worker | 11044 Mount Belvedere Blvd, Fort Drum, NY 13602 | 2018-12-17 |
| 1720555253 | Elizabeth M Hover | Social Worker | P11050 Mt Belvedere Blvd, Fort Drum, NY 13602 | 2018-11-02 |
| 1376037424 | Phillip Dakotah Mitchell | Physician Assistant | 10020 Euphrates River Valley Road, Fort Drum, NY 13602 | 2018-06-20 |
| 1063902666 | Guthrie Ahc | Clinic/Center | P19914 M3r Tampa, Fort Drum, NY 13602 | 2018-05-18 |
| 1255846879 | Morgan Elizabeth Callari | Dental Hygienist | 10205 S Riva Ridge Loop, Fort Drum, NY 13602 | 2017-12-05 |
| 1609389097 | John Charles Bockmann | Physician Assistant | Connor Troop Medical Clinic, 10506 Euphrates River Valley Rd, Fort Drum, NY 13602 | 2017-11-08 |
| 1902318207 | Nicholas Andrew Jones | Military Health Care Provider | 10506 S. Riva Ridge, Fort Drum, NY 13602 | 2017-10-26 |
| 1508389198 | Richard Scott Christiansen | Physical Therapist | 10330 S Riva Ridge Loop, Fort Drum, NY 13602 | 2017-07-25 |
| 1811418098 | Emer B Bajuelos | Dentist | Ft Drum W07uaa 10590, Ft Drum, Apo, AP 13602 | 2017-06-28 |
| Find all providers in zip 13602 | ||||
| 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 |
|---|---|---|---|---|
| 1255846879 | Morgan Elizabeth Callari | Dental Hygienist | 10205 S Riva Ridge Loop, Fort Drum, NY 13602 | 2017-12-05 |
| 1477977940 | Whitney Tarkington | Dental Hygienist | 99114b Forest Dr, Fort Drum, NY 13603-3415 | 2014-02-04 |
| 1821500802 | Bianca Garcia | Dental Hygienist | 10590 Enduring Freedom Dr, Fort Drum, NY 13602-5005 | 2017-10-30 |
| 1881103521 | Elizabeth Haley Fowler | Dental Hygienist | 10590 Enduring Freedom Drive, Us Army Dental Activity, Fort Drum, NY 13602-5005 | 2017-09-26 |
| 1952856114 | Jane Bowers | Dental Hygienist | 10590 Enduring Freedom Drive, Fort Drum, NY 13602-5005 | 2016-08-17 |
| 1881043578 | Julie Grieco | Dental Hygienist | 10590 Enduring Freedom Dr, Fort Drum, NY 13602-5005 | 2016-06-03 |
| 1770932469 | Diane Misercola | Dental Hygienist | 10590 Enduring Freedom Dr, Fort Drum, NY 13602-5005 | 2016-06-03 |
| 1548619208 | Margaret Fargo | Dental Hygienist | 10590 Enduring Freedom Dr, Fort Drum, NY 13602-5005 | 2016-06-03 |
| 1598114282 | Prany Powell | Dental Hygienist | 10590 Enduring Freedom Dr, Fort Drum, NY 13602-5005 | 2016-06-03 |
| 1073961702 | Roxanne Lawler | Dental Hygienist | 10590 Enduring Freedom Dr, Fort Drum, NY 13602-5005 | 2016-06-03 |
| Find all providers in FORT DRUM | ||||
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| 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.