Bergendahl, Kellie Renee
Bergendahl, Kellie Renee is an individual health care provider with primary practice located at 427 12Th St , Plummer ID 83851-4000. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Bergendahl, Kellie Renee can be contacted via phone (208) 686-1931.Contact Information
Primary practice address
427 12Th St
Plummer ID 83851-4000
Phone: (208) 686-1931
Fax: (208) 686-5133
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Hygienist | 124Q00000X | DH2335 | Idaho |
Profile Details
| NPI number | 1053563619 |
|---|---|
| LBN Legal business name | Bergendahl, Kellie Renee |
| Credentials | Registered Dental Hygienist (RDH) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 15th, 2008 |
| Last updated | Sep 23rd, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053563619 | NPPES |
| California | Other | RDH 20164 | STATE LICENSE |
Popular Providers
-
Prockelo, Kimberley K.
4175 S Alamo Ave , Dm Afb AZ 85707-6097 -
Rogers, Denise
982 E Main St , Bridgeport CT 06608-1913 -
Laplante, Cathleen L
1115 B St , Plummer ID 83851-0388 -
Mccoy, Hollie Elizabeth
Branch Health Clinic,Naval Amphibious Base,Little Creek 1035 Nider Blvd, Suite 100, Norfolk VA 23521-2731 -
Wilson, Jack Anthony
2654 Stacey Way , National City CA 91950-7760 -
Moreno, Joe
202 Pomfret St , Putnam CT 06260-1833 -
Roberson, Nekeia Remoan
Bldg. 277 Code 100D Naval Medical Center Portsmouth - N, Portsmouth VA 23709 -
Kreger, Elizabeth Ann
614 E Alder St Ste 4, Walla Walla WA 99362-2073