KYLE ANDREW SHACKELFORD (NPI# 1689130064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689130064 |
| Entity Type | Individual |
| Full Name | KYLE ANDREW SHACKELFORD |
| Credential | RDH |
| Practice Address |
6165 Valley Springs Pkwy Ste E Riverside CA 92507-0955 |
| Mailing Address |
1301 W Heald Ave Lake Elsinore CA 92530-3207 |
| Practice Telephone | 9512146585 |
| Mailing Telephone | 9518376092 |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2019-02-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 32608 | CA | Dental Providers |
| Street Address |
6165 VALLEY SPRINGS PKWY STE E |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92507-0955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448917 | Rachel Nielson | Counselor | 1450 Spruce St, Suite A, Riverside, CA 92507 | 2020-08-24 |
| 1437769742 | Pakravan, Manavi & Cohen Dental Corporation | Dentist | 2862 Unit B Canyon Springs Parkway, Riverside, CA 92507 | 2020-08-03 |
| 1518577972 | Michael Vincent Laureola Dds Inc | Dentist | 2862 Unit A Canyon Springs Parkway, Riverside, CA 92507 | 2020-07-31 |
| 1164067567 | Audrey Gruen | Social Worker | Canyon Crest Mental Health, 5225 Canyon Crest Drive #100, Riverside, CA 92507 | 2019-11-10 |
| 1518432962 | Antonio Mixon | Specialist | 1405 Spruce Street, Suite A, Riverside, CA 92507 | 2018-10-11 |
| 1811479793 | New Day Counseling Services | Counselor | 20363 Harvard Way, Riverside, CA 92507 | 2018-09-06 |
| 1780176875 | Miriam Martinez | Case Manager/Care Coordinator | 2085 Rustin Ave., Riverside, CA 92507 | 2018-06-04 |
| 1518478874 | Lisa Manuel | Counselor | 2058 Rustin Ave, Riverside, CA 92507 | 2017-10-13 |
| 1497272942 | Yajaira Placensia | Behavioral Analyst | 1486 Everton Place, Riverside, CA 92507 | 2017-08-25 |
| 1841717691 | Stephanie Teuchert | Behavioral Analyst | 1080 Spruce Street Apartment 7c, Riverside, CA 92507 | 2017-08-23 |
| Find all providers in zip 92507 | ||||
| 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 |
|---|---|---|---|---|
| 1376993766 | Olga Rubalcava | Dental Hygienist | 5911 Steve St, Riverside, CA 92509-4784 | 2016-06-15 |
| 1356718217 | Jennifer Weitzel | Dental Hygienist | 7611 Lippizan Dr, Riverside, CA 92509-5326 | 2015-08-26 |
| 1679822209 | Marcia Espinoza | Dental Hygienist | 375 Central Ave, 58, Riverside, CA 92507 | 2012-08-29 |
| 1770882854 | Selina Marie Armenta | Dental Hygienist | 17529 Burl Hollow Dr, Riverside, CA 92504-8847 | 2011-03-15 |
| 1194977751 | Jean Margaret Honny | Dental Hygienist | 18775 Chickory Dr, Riverside, CA 92504-9526 | 2008-10-15 |
| 1144853532 | Austin Cardenas | Dental Hygienist | 3380 La Sierra Ave Ste 108, Riverside, CA 92503-5225 | 2020-02-13 |
| 1609390178 | Chimera Charmaine Williams | Dental Hygienist | 3630 Central Ave Ste 6, Riverside, CA 92506-5903 | 2017-07-27 |
| 1639426125 | Amber Elaine Bowen | Dental Hygienist | 7154 Magnolia Ave, Riverside, CA 92504-3804 | 2012-08-14 |
| 1730435207 | Brenda P Powers | Dental Hygienist | 7154 Magnolia Ave, Riverside, CA 92504-3804 | 2012-08-01 |
| 1134474596 | Gemma Atiga Agustines | Dental Hygienist | 7154 Magnolia Ave, Riverside, CA 92504-3804 | 2012-07-20 |
| Find all providers in RIVERSIDE | ||||
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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.