ANGEL HARDISON (NPI# 1720496631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720496631 |
| Entity Type | Individual |
| Full Name | ANGEL HARDISON |
| Practice Address |
554 Keily Street Bureau of Medicine and Surgery Ccpd Jacksonville FL 32212 |
| Practice Telephone | 7579536509 |
| Mailing Telephone | 7579536509 |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2014-07-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 0402206280 | VA | Dental Providers |
| Street Address |
554 KEILY STREET BUREAU OF MEDICINE AND SURGERY CCPD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326019373 | Brian G Norwood | Pediatrics | 554 Keily Street, Jacksonville, FL 32212 | 2006-01-29 |
| 1811461726 | Yocelin Hernandez Rojero | Occupational Therapist | 554 Keily Street, Jacksonville Fl 32212, Jacksonville, FL 32212 | 2019-01-14 |
| 1609381235 | Miranda Shilelagh Schmidt | Physician Assistant | 554 Keily Street, Jacksonville, FL 32212 | 2017-12-05 |
| 1144733627 | Tylisha Elyse Deshields | Social Worker | 554 Keily Street, Jacksonville, FL 32212 | 2017-11-07 |
| 1326557976 | David Michael Tatera | Psychologist | 554 Keily Street, Jacksonville, FL 32212 | 2017-09-27 |
| 1104335348 | Kuang-hui Lee | General Practice | 554 Keily Street, Jacksonville, FL 32212 | 2017-09-20 |
| 1548788177 | Sophia Renee Beal | Speech-Language Pathologist | 554 Keily Street, Jacksonville, FL 32212 | 2017-09-04 |
| 1164949418 | George S Bennitt | Dentist | 554 Keily Street, Jacksonville, FL 32212-4047 | 2017-08-28 |
| 1124545389 | David Phillips | Student in an Organized Health Care Education/Training Program | 554 Keily Street, Centralized Credential and Privileging Directorate, Jacksonville, FL 32212-2466 | 2017-08-28 |
| 1902323652 | Erich Chen | Student in an Organized Health Care Education/Training Program | 554 Keily Street, Jacksonville, FL 32212 | 2017-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952911752 | Jeff Woohyeok Chang | Dentist | 964 Ajax Street, Jacksonville, FL 32212 | 2020-08-06 |
| 1518484427 | Amy Kathryn Lee | Student in an Organized Health Care Education/Training Program | Bumed, Centralized Credential & Privileging Directorate, 554 Keily Street, Jacksonville, FL 32212 | 2017-08-23 |
| 1659827970 | Noah Fixelle | Dentist | Bureau of Med and Surg Ccpd, 554 Keily Street, Jacksonville, VA 32212 | 2016-08-28 |
| 1972953339 | Colin Kenneth Kelly | General Practice | Bureau of Medicine & Surgery Detachment, Nas Jacksonville, Building 554, Jacksonville, FL 32212 | 2016-06-16 |
| 1912382359 | Caitlyn Brooke Hoysock | Dentist | 554 Keiley Street, Bureau of Medicine and Surgery - Credentials, Jacksonville, FL 32212 | 2015-07-28 |
| 1285017418 | John Alexander Ruch | Dentist | 554 Keily Street Bureau of Med and Surg Ccpd, Jacksonville, FL 32212 | 2015-07-07 |
| 1407238561 | Amanda Mona Lau | Student in an Organized Health Care Education/Training Program | 554 Kelly Street, Attn Centralized Credentialing, Bureau of Medicine and Surgery, Jacksonville, FL 32212 | 2015-06-25 |
| 1063894715 | Heather Dehaan | Family Medicine | 554 Kelly Street Bureau of Medicine and Surgery, Attention: Centralized Credentialing & Privileging Dire, Jacksonville, FL 32212 | 2015-06-18 |
| 1912389677 | Catherine Garcia | Student in an Organized Health Care Education/Training Program | 554 Kelly St, Credentialing & Privileging Directorate, Bureau of Medicine & Surgery, Attention: Centralized, Jacksonville, FL 32212 | 2015-06-18 |
| 1255712675 | James Robert Benson | Dentist | 734 Keily Street, Bumed, Jacksonville, FL 32212 | 2015-06-11 |
| Find all providers in zip 32212 | ||||
| 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 |
|---|---|---|---|---|
| 1962012328 | Melody Jean Garcia | Dental Hygienist | Navy Medicene Support Command : Medical Staff Services, Bldg H, 2005 Knight Lane, Jacksonville, FL 32221-0140 | 2020-07-31 |
| 1659918985 | Iris E Fernandezregis | Dental Hygienist | Medical Staff Svcs, Bldg H 2005 Knight Lane, Jacksonville, FL 32212-0140 | 2019-12-05 |
| 1508341694 | Tommie Janae Kell | Dental Hygienist | 235 W Main St Fl 2, Jacksonville, OR 97530-9278 | 2018-09-25 |
| 1457759722 | Yue Wang | Dental Hygienist | 554 Keily Street - Bureau of Medicine and Surgery, Credentialing and Privileging, Jacksonville, FL 32212 | 2014-12-18 |
| 1295132017 | Trupti Patel | Dental Hygienist | 554 Keily St - Bureau of Medicine and Surgery, Certralized Credentials, Jacksonville, FL 32212 | 2014-11-21 |
| 1497185060 | Kelly Pickton | Dental Hygienist | 554 Keily St Bumed Ccp Directorate, Jacksonville, FL 32212 | 2013-11-19 |
| 1073866679 | Aubrie Leigh Tanner | Dental Hygienist | 7933 Baymeadows Way Ste 5, Jacksonville, FL 32256-7514 | 2012-10-19 |
| 1336492024 | Donna Mahacek | Dental Hygienist | 2764 Sebastian Ct, Jacksonville, FL 32224-2896 | 2012-10-18 |
| 1457518755 | Patricia Louise Jakubec | Dental Hygienist | 13226 Moby Dick Dr W, Jacksonville, FL 32218-2891 | 2008-05-22 |
| 1659464055 | Ernesto Aleniado Soberano | Dental Hygienist | 301 Preston Rd, Jacksonville, NC 28540-5656 | 2006-09-30 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32212 |
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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.