DEBRA L VINE (NPI# 1851847131) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851847131 |
| Entity Type | Individual |
| Full Name | DEBRA L VINE |
| Practice Address |
12720 Kansas Ave Bldg 789 Fort Leonard Wood MO 65473 |
| Mailing Address |
12720 Kansas Ave 720 Ft. Leonard Wood MO 65473 |
| Practice Telephone | 5735961470 |
| Practice Fax Number | 5735961482 |
| Mailing Telephone | 5735961470 |
| Mailing Fax Number | 5735961482 |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-08-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 126800000X | Dental Assistant | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245404052 | Debra K Vine | Occupational Therapist | N112w17975 Mequon Rd, Germantown, WI 53022-2425 | 2008-04-14 |
| Street Address |
12720 KANSAS AVE BLDG 789 |
| City | FORT LEONARD WOOD |
| State | MO |
| Zip Code | 65473 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548656044 | General Leonard Wood Army Community Hospital | Clinic/Center | 12720 Kansas Ave, Bldg 789, Fort Leonard Wood, MO 65473 | 2015-04-10 |
| 1902352743 | Jill Stephanie Simono | Dental Assistant | 12720 Kansas Ave, Bldg 789, Fort Leonard Wood, MO 65473 | 2016-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770192759 | Clara Boo Chai | Physician Assistant | General Leonard Wood Army Community Hospital, 4430 Missouri Ave, #1267, Fort Leonard Wood, MO 65473 | 2020-07-27 |
| 1982198453 | Traci Anne Shambo | Dental Hygienist | Bldg. 400 Virginia Ave, Fort Leonard Wood, MO 65473 | 2018-06-19 |
| 1083133771 | Mary Joan Klemp | Family Medicine | Ganeral Leonard Wood Army Community Hospital, 4430 Missouri Ave; Meddac Case Management; Primary Care, Fort Leonard Wood, MO 65473 | 2017-09-13 |
| 1255791851 | Sarah Elizabeth Joy | Physician Assistant | 885 West 16th Street, Fort Leonard Wood, MO 65473 | 2016-02-25 |
| 1548626948 | Jaimie-lee Musen | Physical Therapist | 4430 Missouri Ave, Glwach, Fort Leonard Wood, MO 65473 | 2016-01-14 |
| 1609240852 | Angela Carson | Registered Nurse | 4330 Missouri Avenue, Fort Leonard Wood, MO 65473 | 2015-11-25 |
| 1811379407 | Katharine Leigh Stringer | Dentist | 12720 Kansas Avenue, Fort Leonard Wood, MO 65473 | 2015-06-19 |
| 1740670314 | Terricka Stewart | Specialist/Technologist | 885 West 16th St., Fort Leonard Wood, MO 65473 | 2015-02-03 |
| 1427467265 | Dianna Morrison | Social Worker | 4430 Missouri Ave Box 1278, Fort Leonard Wood, MO 65473 | 2014-08-06 |
| 1265848634 | Rachel Lopp | Specialist/Technologist | Bld 901, Room 131, Fort Leonard Wood, MO 65473 | 2014-07-07 |
| Find all providers in zip 65473 | ||||
| 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 |
|---|---|---|---|---|
| 1316434277 | Kendra Jasmin Butcher | Dental Assistant | 5047 Virginia Ave Bldg 500, Fort Leonard Wood, MO 65473-9126 | 2018-04-17 |
| 1821544438 | Linda Ann Glick | Dental Assistant | 5047 Virginia Ave., Fort Leonard Wood, MO 65473-1317 | 2016-09-01 |
| 1942652086 | Robert Bartholomew Poulard | Dental Assistant | 4566 Oklahoma Ave, Bldg 2100, Fort Leonard Wood, MO 65473-1638 | 2016-07-12 |
| 1427505973 | Monika Torres | Dental Assistant | 12720 Kansas Avenue, Fort Leonard Wood, MO 65473 | 2016-09-01 |
| 1902352743 | Jill Stephanie Simono | Dental Assistant | 12720 Kansas Ave, Bldg 789, Fort Leonard Wood, MO 65473 | 2016-08-31 |
| 1699228668 | Lori Roam | Dental Assistant | 5047 Virginia Ave, Bldg 500, Fort Leonard Wood, MO 65473-9126 | 2016-07-26 |
| 1790138360 | Dawn Renee Kubinski | Dental Assistant | 5047 Virginia Ave, Bldg 500, Fort Leonard Wood, MO 65473 | 2016-07-19 |
| 1306298104 | Brandon Lee Zimmer | Dental Assistant | 5047 Virginia Ave, Bldg 500, Fort Leonard Wood, MO 65473-9126 | 2016-07-06 |
| 1669824306 | Jaya Crossgrove | Dental Assistant | 5047 Virginia Ave, Bldg 500, Fort Leonard Wood, MO 65473-9126 | 2016-07-06 |
| 1871945527 | Juan E Toruno | Dental Assistant | 5047 Virginia Ave, Bldg 500, Fort Leonard Wood, MO 65473-9126 | 2016-07-06 |
| Find all providers in FORT LEONARD WOOD | ||||
| City | FORT LEONARD WOOD |
| Zip Code | 65473 |
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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.