NICOLE SEPULVEDA (NPI# 1881106193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881106193 |
| Entity Type | Individual |
| Full Name | NICOLE SEPULVEDA |
| Credential | 68EN5 |
| Practice Address |
Bldg 171 4th & Inner Loop Road Fort Irwin CA 92310 |
| Practice Telephone | 7195265537 |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2017-10-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 126800000X | Dental Assistant | Dental Providers | ||
| Y | 126900000X | Dental Laboratory Technician | Dental Providers |
| Street Address |
BLDG 171 4TH & INNER LOOP ROAD |
| City | FORT IRWIN |
| State | CA |
| Zip Code | 92310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356897615 | Alan Josiah Mills II | Dental Assistant | Bldg 171, 4th & Inner Loop Road, Fort Irwin, CA 92310 | 2016-08-28 |
| 1780197764 | Akely Shiro | Dental Assistant | Bldg 171, 4th & Inner Loop Road, Fort Irwin, CA 92310 | 2017-11-13 |
| 1609389683 | Joni Kay Sheppard | Dental Assistant | Bldg 171, 4th & Inner Loop Road, Fort Irwin, CA 92310 | 2017-11-13 |
| 1316459639 | Rachael Renee Yarbrough | Dental Assistant | Bldg 171, 4th & Inner Loop Road, Fort Irwin, CA 92310 | 2017-10-26 |
| 1962914374 | Lamar Angelo Leseur | Dental Assistant | Bldg 171, 4th & Inner Loop Road, Fort Irwin, CA 92310 | 2017-10-26 |
| 1841702164 | Marquon Tyquin Jones | Dental Assistant | Bldg 171, 4th & Inner Loop Road, Fort Irwin, CA 92310 | 2017-10-26 |
| 1609388917 | Linda Maria Silva | Dental Assistant | Bldg 171, 4th & Inner Loop Road, Fort Irwin, CA 92310 | 2017-10-26 |
| 1427560739 | Travis Devon Vasquez | Dental Assistant | Bldg 171, 4th & Inner Loop Road, Fort Irwin, CA 92310 | 2017-10-26 |
| 1497267801 | Cindi Lee Bredeson | Dental Assistant | Bldg 171, 4th & Inner Loop Road, Fort Irwin, CA 92310 | 2017-10-26 |
| 1376055681 | Tafaogalupe Swanney | Dental Assistant | Bldg 171, 4th & Inner Loop Road, Fort Irwin, CA 92310 | 2017-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100568 | Kellyann Michelle Francis | Dental Hygienist | 171, 4th St., Fort Irwin, CA 92310 | 2020-10-06 |
| 1598362253 | Lauren Elisabeth O'keefe | Dental Hygienist | 172 4th Street, Fort Irwin, CA 92310 | 2020-10-06 |
| 1215583737 | Lyra Angelica Velayo Matin | Marriage & Family Therapist | Bldg 390 N Loop Road, Fort Irwin, CA 92310 | 2019-08-12 |
| 1003384629 | Gary Barrow | Chiropractor | 390 Outerloop Rd, Fort Irwin, CA 92310 | 2018-11-13 |
| 1801373055 | Lee John Bizon Jr. | Nurse Practitioner | 390 North Loop Rd, Fort Irwin, CA 92310 | 2018-07-20 |
| 1619489937 | Ronda Marie Shiro | Dental Assistant | 171 Inner Loop Rpad, Fort Irwin, CA 92310 | 2017-10-26 |
| 1841713195 | James Degroot | Registered Nurse | Weed Army Community Hospital 390 North Loop Rd., Fort Irwin, CA 92310 | 2017-07-19 |
| 1568917136 | Kathryn Paine | Physical Therapist | Building 390, North Loop Rd, Fort Irwin, CA 92310 | 2016-08-23 |
| 1487003588 | Kristyn Lauren Ollison | Dental Assistant | Bldg 248 A Meddac, Fort Irwin, CA 92310 | 2016-06-09 |
| 1043676463 | National Vision, Inc. | Technician/Technologist | Langford Lake Rd, Bldg 918, Ft Irwin, CA 92310 | 2016-01-14 |
| Find all providers in zip 92310 | ||||
| Taxonomy Code | 126900000X |
| Grouping | Dental Providers |
| Classification | Dental Laboratory Technician |
| An individual who has the skill and knowledge in the fabrication of dental appliances, prostheses and devices in accordance with a dentist's laboratory work authorization. To avoid misleading the public, no occupational title other than dental laboratory technician or certified dental technician (when appropriate) should be used to describe this auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700398021 | Jonathan Rivera | Dental Laboratory Technician | 2605 Saint Mihiel St, Fort Irwin, CA 92310-1654 | 2017-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801416300 | Sun Hong | Dental Laboratory Technician | 1500 Los Padres Blvd Ste 102, Santa Clara, CA 95050-4462 | 2020-04-24 |
| 1528600640 | Mingyeong Kim | Dental Laboratory Technician | 20311 Stevens Creek Blvd Ste 1b, Cupertino, CA 95014-2230 | 2019-10-09 |
| 1700337201 | Christopher Robold | Dental Laboratory Technician | 3772 Katella Ave Ste 106, Los Alamitos, CA 90720-6418 | 2016-10-19 |
| 1225451545 | Roobik Ebrahimi | Dental Laboratory Technician | 2101 Broadview Dr Ste C, Glendale, CA 91208-1355 | 2014-01-22 |
| 1205971306 | Hatcher & Dial Inc. | Dental Laboratory Technician | 1 Scripps Dr Ste 101, Sacramento, CA 95825-6206 | 2007-02-20 |
| 1154819464 | Young Dong Chung | Dental Laboratory Technician | 700 N Valley St Ste F-g, Anaheim, CA 92801-3824 | 2018-04-23 |
| City | FORT IRWIN |
| Zip Code | 92310 |
Please comment or provide details below to improve the information on NICOLE SEPULVEDA.
| 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.