JEANIE COLVIN (NPI# 1700239217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700239217 |
| Entity Type | Individual |
| Full Name | JEANIE COLVIN |
| Credential | ADDP COORDINATOR |
| Practice Address |
11572 17th and C St. Jblm WA 98433 |
| Practice Telephone | 2539667680 |
| Practice Fax Number | 2539677216 |
| Mailing Telephone | 2539667680 |
| Mailing Fax Number | 2539677612 |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2019-08-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 126800000X | Dental Assistant | Dental Providers |
| Street Address |
11572 17TH AND C ST. |
| City | JBLM |
| State | WA |
| Zip Code | 98433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739881 | Bryonna Floyd | Dental Assistant | 11572 17th & C Street, Joint Base Lewis-mcchord, WA 98433 | 2020-08-07 |
| 1790393213 | Matthew T Ellison | Dentist | Dental Clinic 2, 3740 South 14th St., Joint Base Lewis-mcchord, WA 98433 | 2020-07-21 |
| 1952933251 | Julie Kristen Dutler | Dental Hygienist | 11572 C St, Jblm, WA 98433 | 2020-02-05 |
| 1881224806 | James Eric Carvelli | Dental Assistant | 11572 17th Street & C Street, Joint Base Lewis Mcchord, WA 98433 | 2020-01-17 |
| 1245891019 | Tanya Latrell Lesane | Counselor | 9924b W. Johnson St, Joint Base Lewis0mcchord, WA 98433 | 2019-06-24 |
| 1740844224 | Allison Tracy Bertoni | Student in an Organized Health Care Education/Training Program | 3740 South 14th Street, Joint Base Lewis-mcchord, WA 98433 | 2019-04-30 |
| 1124682448 | Lori Ann Sage | Registered Nurse | Building 11582, 17th & C Street, Joint Base Lewis-mcchord, WA 98433 | 2019-04-23 |
| 1639645997 | Emily Elisabeth Armstrong | Emergency Medical Technician, Paramedic | 3370 Evergreen Ave, Jblm, WA 98433 | 2018-10-15 |
| 1982182101 | Won Kyung Yang | Dentist | 11582 C St., Jblm, WA 98433 | 2018-07-31 |
| 1205325966 | Gloria Judith Penate I | Dental Hygienist | 2103 North Division Street, Tacoma, WA 98433 | 2018-05-08 |
| Find all providers in zip 98433 | ||||
| Taxonomy Code | 126800000X |
| Grouping | Dental Providers |
| Classification | Dental Assistant |
| An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609387141 | Angela Maria Lewis | Dental Assistant | Bldg 11572 17th & C St, Jblm, WA 98433 | 2017-10-23 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1144881970 | Chartise George | Dental Assistant | 11572 17th and C. Street, Jblm, WA 98433 | 2019-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739881 | Bryonna Floyd | Dental Assistant | 11572 17th & C Street, Joint Base Lewis-mcchord, WA 98433 | 2020-08-07 |
| 1932726049 | Usama Al Saedi | Dental Assistant | 1421 Nw 85th St Apt 110, Seattle, WA 98117-4298 | 2020-07-06 |
| 1881224806 | James Eric Carvelli | Dental Assistant | 11572 17th Street & C Street, Joint Base Lewis Mcchord, WA 98433 | 2020-01-17 |
| 1932747961 | Riley Whipple | Dental Assistant | 1401 S 45th Ave, West Richland, WA 99353-7904 | 2019-12-20 |
| 1700423274 | Beenish Farooq | Dental Assistant | 10710 Ne 10th St Apt 1702, Bellevue, WA 98004-1068 | 2019-12-04 |
| 1881241206 | Adena Suen Mangkornkeo | Dental Assistant | 14827 80th Ave Se, Snohomish, WA 98296-8407 | 2019-08-21 |
| 1043864127 | Traci Guan | Dental Assistant | 2027 196th St Sw Ste R1, Lynnwood, WA 98036-7073 | 2019-07-28 |
| 1316408578 | Moises Cerecedo Rios | Dental Assistant | 512 5th Ave W Apt 6, Seattle, WA 98119-3944 | 2019-03-28 |
| 1881161818 | Michelle Wolfe | Dental Assistant | A101, 1484, 14313 Ne 20th Ave, Vancouver, WA 98686 | 2018-10-29 |
| 1134615735 | Ronda Mechelle Pugaczewski | Dental Assistant | 12621 164th St E, Puyallup, WA 98374-9523 | 2018-07-06 |
| Find all providers with the same taxonomy | ||||
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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.