MRS. KIMBERLEY K. PROCKELO (NPI# 1881664076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881664076 |
| Entity Type | Individual |
| Full Name | MRS. KIMBERLEY K. PROCKELO |
| Credential | RDH |
| Practice Address |
4175 S Alamo Ave Dm Afb AZ 85707-6097 |
| Mailing Address |
Po Box 23936 Tucson AZ 85734-3936 |
| Practice Telephone | 5202282651 |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | H1617 | AZ | Dental Providers |
| Street Address |
4175 S ALAMO AVE |
| City | DM AFB |
| State | AZ |
| Zip Code | 85707-6097 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255560025 | Daniel Nored | Military Health Care Provider | 4175 S Alamo Ave, Dm Afb, AZ 85707-4402 | 2009-07-14 |
| 1598929440 | Lucretia Lynne Vaughan | Psychiatry & Neurology | 4175 S Alamo Ave, Dm Afb, AZ 85707-4402 | 2008-07-10 |
| 1033184551 | Nancy Christy | Nurse Practitioner | 4175 S Alamo Ave, Building 400, Dm Afb, AZ 85707-6097 | 2006-02-19 |
| 1346220860 | Troy John Selby | Physician Assistant | 4175 S Alamo Ave, Dm Afb, AZ 85707-6097 | 2006-01-19 |
| 1063492502 | Carl Wayne Dasse | Family Medicine | 4175 S Alamo Ave, Dm Afb, AZ 85707-6097 | 2006-01-19 |
| 1235117292 | Leslie Shigetani | Dentist | 4175 S Alamo Ave, Dm Afb, AZ 85707-4402 | 2006-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699128850 | Megan Dehaven | Specialist/Technologist | 5455 E Comanche St, Tucson, AZ 85707 | 2016-07-22 |
| 1780927954 | Ryan N Taylor | Physician Assistant | 400, 4175 S Alamo Ave, Davis-monthan Afb, AZ 85707 | 2013-04-05 |
| 1154658839 | Alisha A Marchetti | Physician Assistant | 4175 S. Alamo Avenue, 355th Mdg/mdos, Davis-monthan Afb, AZ 85707 | 2009-11-17 |
| 1851529192 | Christopher Thomas Yarbrough | Military Health Care Provider | 4625 South Phoenix Street Bldg 4843, Tucson, AZ 85707 | 2009-06-25 |
| 1144457045 | Denise Fabian | Psychiatry & Neurology | 5427 E. Madera Street, Davis Monthan Afb, AZ 85707 | 2009-06-17 |
| 1942437447 | Emerson M Earle | Military Health Care Provider | 4625 S. Phoenix St, Bld 4843, Tucson, AZ 85707 | 2009-06-11 |
| 1164657136 | Raul Romero | Military Health Care Provider | 4575 S. Phoenix St. 563rd Oss, Dmafb, AZ 85707 | 2009-05-20 |
| 1063647196 | Virginia E. Bailey | Military Health Care Provider | 4837 S Phoenix St., Rm 119 Davis-monthan Air Force Base, Tucson, AZ 85707 | 2009-05-19 |
| 1043417611 | Jacob Riis | Orthopaedic Surgery | 355 Mdg, 4175 South Alamo Ave, Tucson, AZ 85707 | 2007-06-28 |
| 1508989732 | Christopher E. Dunham | Physician Assistant | 4175 S. Alamo Ave Bldg 400, 355th Medical Group-davis Monthan Afb, Tucson, AZ 85707 | 2007-04-10 |
| Find all providers in zip 85707 | ||||
| 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 |
|---|---|---|---|---|
| 1760096085 | Jerry Lee Collins Jr. | Dental Hygienist | 5205 E Cortland Blvd, Flagstaff, AZ 86004-9362 | 2020-09-03 |
| 1417560608 | Nicholette Congdon | Dental Hygienist | 208 E Knoles Drive, Flagstaff, AZ 86011-0001 | 2020-08-26 |
| 1093328437 | Ryan M Fisher | Dental Hygienist | 3300 S Gila Dr Apt 1, Flagstaff, AZ 86005-6537 | 2020-08-25 |
| 1609484369 | Sarah Lewallen | Dental Hygienist | 14804 N Cave Creek Rd # 105, Phoenix, AZ 85032-4945 | 2020-07-20 |
| 1033735402 | Denise Muesch Helm | Dental Hygienist | 1320 S Hilltop Ln, Cornville, AZ 86325-5143 | 2020-06-22 |
| 1134786726 | Lisa Dawn Russo | Dental Hygienist | 2855 E Blackhawk Ct, Gilbert, AZ 85298-1003 | 2019-05-20 |
| 1093274466 | Sarah Carter | Dental Hygienist | 801 N Wilmot Rd Ste B1, Tucson, AZ 85711-1708 | 2019-03-15 |
| 1679042378 | Jessica Marie Florez | Dental Hygienist | 12425 W Bell Rd Ste 120, Surprise, AZ 85378-9022 | 2018-11-26 |
| 1467921478 | Amy M Fulps | Dental Hygienist | 235 W Catalina Dr, Safford, AZ 85546-2537 | 2018-11-19 |
| 1649765868 | Kaitlyn April Ornelas | Dental Hygienist | 228 London Bridge Rd, Lake Havasu City, AZ 86403-4685 | 2018-06-29 |
| 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.