KELLEY JESSICA QUOLAS (NPI# 1871087163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871087163 |
| Entity Type | Individual |
| Full Name | KELLEY JESSICA QUOLAS |
| Credential | RDH |
| Practice Address |
2155 W Pinnacle Peak Rd Ste 201 Phoenix AZ 85027-1203 |
| Practice Telephone | 6237346631 |
| Mailing Telephone | 6237346631 |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2018-06-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 125J00000X | Dental Therapist | H06628 | AZ | Dental Providers |
| Street Address |
2155 W PINNACLE PEAK RD STE 201 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85027-1203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124080932 | Paul N Sarmiento | Family Medicine | 2155 W Pinnacle Peak Rd Ste 201, Phoenix, AZ 85027-1203 | 2006-04-05 |
| 1457972416 | Mckenzie Care Solutions | In Home Supportive Care | 2155 W Pinnacle Peak Rd Ste 201, Phoenix, AZ 85027-1203 | 2020-04-30 |
| 1598305757 | My Myo My Health, LLC | Clinic/Center | 2155 W Pinnacle Peak Rd Ste 201, Phoenix, AZ 85027-1203 | 2020-01-15 |
| 1134615107 | Regal Counseling Pllc | Social Worker | 2155 W Pinnacle Peak Rd Ste 201, Phoenix, AZ 85027-1203 | 2018-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891306312 | Ashley Nicole Felipe | Registered Nurse | 25700 N 21st Ave, Phoenix, AZ 85027 | 2020-08-10 |
| 1942784376 | Crystal Rodriguez | Dentist | 2550 W Union Hills Dr Ste 201, Phoenix, AZ 85027 | 2018-09-21 |
| 1790284776 | Lydia Kuuipo Chong | Nurse Practitioner | 20414 N 27th Ave #300, Phoenix, AZ 85027 | 2018-02-06 |
| 1457867004 | Kristi Marie Mathews | Nurse Practitioner | 19829 N 29th Avenue, Phoenix, AZ 85027 | 2017-12-19 |
| 1710348362 | The Empower House, LLC | Community Based Residential Treatment Facility, Mental Illness | 18631 N. 19th Ave., Suite 158-305, Phoenix, AZ 85027 | 2016-03-10 |
| 1972979656 | Dr Daniel H Yohannes D.d.s., PC | Dentist | 602 W. Union Hills Dr, #8, Phoenix, AZ 85027 | 2015-08-17 |
| 1013346857 | Dentistry At 35th Avenu | Dentist | 18635 N 35th Avenue, Phoenix, AZ 85027 | 2013-11-02 |
| 1437592102 | Ammar Alobaidy | Psychiatry & Neurology | 21410 N 19th Ave Ste 151, Phoenix, AZ 85027 | 2013-04-12 |
| 1588900021 | Jill Elizabeth Maroscia | Social Worker | 19636 N 27th Ave #106, Phoenix, AZ 85027 | 2013-01-02 |
| 1124394515 | Sfjg Holdings LLC | Dentist | 3414 W. Union Hills Dr, Suite 12 & 14, Phoenix, AZ 85027 | 2012-03-29 |
| Find all providers in zip 85027 | ||||
| Taxonomy Code | 125J00000X |
| Grouping | Dental Providers |
| Classification | Dental Therapist |
| A Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the relevant state board or a tribal entity to provide services within the scope of their practice under the supervision of a dentist. Functions that may be delegated to the dental therapist vary based on the needs of the dentist, the educational preparation of the dental therapist and state dental practice acts and regulations. |
| Notes: Source: Summarized from Minnesota Statute 150A.105. [7/1/2012: new] |
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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.