SHELLY ANNE WITHERS (NPI# 1689826653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689826653 |
| Entity Type | Individual |
| Full Name | SHELLY ANNE WITHERS |
| Credential | BS, RDH, MS |
| Practice Address |
11092 Anderson St Loma Linda CA 92350-1706 |
| Practice Telephone | 9095584631 |
| Practice Fax Number | 9095580313 |
| Mailing Telephone | 9095584631 |
| Mailing Fax Number | 9095580313 |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2014-10-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 124Q00000X | Dental Hygienist | H5578 | OR | Dental Providers |
| Y | 124Q00000X | Dental Hygienist | RDH 19010 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE LICENSE | RDH 19010 | 01 |
| Street Address |
11092 ANDERSON ST |
| City | LOMA LINDA |
| State | CA |
| Zip Code | 92350-1706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114912854 | Nathan Alexander Dinsbach | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2005-09-20 |
| 1134736366 | Mel-anizi Abante Bersaba | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2020-10-01 |
| 1205454683 | Marilyn Tago | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2020-07-11 |
| 1366095143 | Akinlolu Tolulope Jegede | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2019-07-19 |
| 1992360705 | Alexander Borisovich Zaykov | Student in an Organized Health Care Education/Training Program | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2019-05-07 |
| 1619450020 | Carlos Alberto Poni | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2018-09-11 |
| 1780175513 | Lin Jing | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2018-05-29 |
| 1336630177 | Roya Mahmoodi | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2018-05-29 |
| 1740771583 | Susan Q Xu | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2018-05-29 |
| 1881191872 | Janine Tran | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2018-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164059010 | Stephanie Abandy | Student in an Organized Health Care Education/Training Program | 11262 Campus Street - West Hall, West Hall, Loma Linda, CA 92350 | 2020-03-23 |
| 1275911844 | Rosemarie Florian | Internal Medicine | 11234 Anderson St Rm 1503, Loma Linda, CA 92350 | 2015-05-14 |
| 1235525403 | Diana Derosa Villarreal | Pediatrics | 11175 Campus St. Cp-a1111, Department of Pediatrics, Loma Linda, CA 92350 | 2015-04-14 |
| 1609212919 | Daniel Eldridge Smith | Surgery | 11175 Campus St # 21111, Loma Linda, CA 92350 | 2013-05-14 |
| 1992057269 | Hildemar Feliciano Dos Santos | Nutritionist | 25040 Stewart Street, Loma Linda, CA 92350 | 2012-10-10 |
| 1184910762 | Kristyn Anne Mannoia | Surgery | 11234 Anderson Ave Ste 2100, Loma Linda, CA 92350 | 2011-06-22 |
| 1760774947 | Loma Linda University | Special Hospital | 1234 Anderson Street, Gme Office Csp 21005, Loma Linda, CA 92350 | 2011-05-06 |
| 1144547977 | Andrei Radulescu | Surgery | 11175 Campus St Ste 21111, Loma Linda, CA 92350 | 2010-05-04 |
| 1619102845 | Wing Sze Esther Yung | Surgery | 11175 Campus Street #21111, Loma Linda Universiy Healthcare System, Loma Linda, CA 92350 | 2009-05-18 |
| 1679720734 | Ronald Lee Young | Dentist | 11092 Anderson Streeet, Llu School of Dentistry, Loma Linda, CA 92350 | 2008-08-20 |
| Find all providers in zip 92350 | ||||
| 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 |
|---|---|---|---|---|
| 1770180242 | Aireana Marie Smith | Dental Hygienist | 11092 Anderson Streer, Loma Linda, CA 92350-0001 | 2020-10-07 |
| 1003438722 | Anne Golden | Dental Hygienist | 25876 Kellogg St, Loma Linda, CA 92354-3919 | 2020-05-15 |
| 1922501592 | Jose E Ponce | Dental Hygienist | 11275 Price Dr, Loma Linda, CA 92354-4876 | 2018-03-09 |
| 1396176046 | Stacy Stroup | Dental Hygienist | 24928 Lawton Ave, Loma Linda, CA 92354-3431 | 2013-12-06 |
| 1699191023 | Alycia Davis | Dental Hygienist | 11201 Benton St, Loma Linda, CA 92357-1000 | 2014-03-10 |
| 1336459155 | Marilynn Jean Heyde | Dental Hygienist | 11092 Anderson Street, Llu School of Dentistry, Loma Linda, CA 92350-0001 | 2010-10-14 |
| 1437469251 | Shelley L. Hayton | Dental Hygienist | 11092 Anderson Street, Llu School of Dentistry, Loma Linda, CA 92350-0001 | 2010-10-14 |
| 1528378346 | Michelle Erin Einig | Dental Hygienist | 11092 Anderson Street, Llu School of Dentistry, Loma Linda, CA 92350-0001 | 2010-10-14 |
| 1376782599 | Janelle Christiana Fairhurst | Dental Hygienist | Llu School of Dentistry, 11092 Anderson Street, Loma Linda, CA 92350-0001 | 2009-02-11 |
| 1144466442 | Carrie Davies | Dental Hygienist | 11092 Anderson Street, Llu School of Dentistry, Loma Linda, CA 92350 | 2008-12-17 |
| Find all providers in LOMA LINDA | ||||
| City | LOMA LINDA |
| Zip Code | 92350 |
Please comment or provide details below to improve the information on SHELLY ANNE WITHERS.
| 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.