KENNA ROSE TYREE (NPI# 1013474501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013474501 |
| Entity Type | Individual |
| Full Name | KENNA ROSE TYREE |
| Credential | RDH |
| Practice Address |
29632 Highway 299 East Round Mountain CA 96084 |
| Mailing Address |
Po Box 228 Round Mountain CA 96084-0228 |
| Practice Telephone | 5303376244 |
| Mailing Telephone | 5303376244 |
| Mailing Fax Number | 5303375791 |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2019-02-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 30456 | CA | Dental Providers |
| Street Address |
29632 HIGHWAY 299 EAST |
| City | ROUND MOUNTAIN |
| State | CA |
| Zip Code | 96084 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407914260 | Hill Country Community Clinic | Clinic/Center | 29632 Highway 299 East, Round Mountain, CA 96084-0228 | 2006-12-05 |
| 1871144402 | Alicia Kaylin Hopper | Dental Hygienist | 29632 Highway 299 East, Round Mountain, CA 96084 | 2019-09-25 |
| 1609152941 | Asa Mark Calkins | Nurse Practitioner | 29632 Highway 299 East, Round Mountain, CA 96084 | 2011-11-01 |
| 1982986170 | Susan Elizabeth Foster | Nurse Practitioner | 29632 Highway 299 East, Round Mountain, CA 96084 | 2011-09-13 |
| 1306179239 | Christopher David Nelson | Dentist | 29632 Highway 299 East, Round Mountain, CA 96084 | 2009-09-10 |
| 1952444986 | Darra A. Husome | Nurse Practitioner | 29632 Highway 299 East, Round Mountain, CA 96084 | 2007-02-15 |
| 1518023894 | James L Logan | Dentist | 29632 Highway 299 East, Round Mountain, CA 96084-0228 | 2006-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497241574 | Lester Diaz Martinez | Dentist | 29632 Highway 299 E, Round Mountain, CA 96084 | 2018-07-02 |
| 1639446099 | Jennifer Ann Franchuk | General Practice | 29632 Hwy 299 East, Round Mountain, CA 96084 | 2011-11-29 |
| 1376731570 | Nathanial R Anderson | Physician Assistant | 29632 Hwy 299e, Round Mountain, CA 96084 | 2007-10-12 |
| 1326688409 | Gurleen Kaur Sidhu | Dentist | 29632 Hwy 299e, Round Mountain, CA 96084 | 2020-01-07 |
| 1033681077 | Hyon Knorr Shaffer | Dental Hygienist | 29632 Hwy 299 East, Round Mountain, CA 96084 | 2018-12-31 |
| 1033235692 | Tammy Allan | Social Worker | 29632 Highway 299e, Round Mountain, CA 96084-0228 | 2007-03-22 |
| 1649737131 | Kristi Michelle Hughes | Dental Hygienist | 29632 Highway 299 E, Round Mountain, CA 96084-0228 | 2019-02-21 |
| 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 |
|---|---|---|---|---|
| 1871144402 | Alicia Kaylin Hopper | Dental Hygienist | 29632 Highway 299 East, Round Mountain, CA 96084 | 2019-09-25 |
| 1649737131 | Kristi Michelle Hughes | Dental Hygienist | 29632 Highway 299 E, Round Mountain, CA 96084-0228 | 2019-02-21 |
| 1033681077 | Hyon Knorr Shaffer | Dental Hygienist | 29632 Hwy 299 East, Round Mountain, CA 96084 | 2018-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841046 | Betty Satomi Fukumoto | Dental Hygienist | 16008 S Manhattan Pl, Gardena, CA 90247-3681 | 2020-11-08 |
| 1417558180 | Maria Antonette De Lara Kim | Dental Hygienist | 66 S San Gorgonio Ave Ste 5, Banning, CA 92220-6020 | 2020-11-07 |
| 1083215982 | Sokbunntha Yan | Dental Hygienist | 5810 Fidler Ave, Lakewood, CA 90712-1251 | 2020-11-06 |
| 1649871914 | Maryam Ghahramani Shahneshin | Dental Hygienist | 1961 Grove Pl, Escondido, CA 92027-4101 | 2020-11-04 |
| 1285234047 | Maryann Detar | Dental Hygienist | 3154 Alum Rock Ave, San Jose, CA 95127-2903 | 2020-10-29 |
| 1194325597 | Connie Lim Good | Dental Hygienist | 14th Street Bldg 13128, Oceanside, CA 92055 | 2020-10-27 |
| 1336748896 | Cynthia Garcia Macdougall | Dental Hygienist | 444 Hermosa Ave Apt 302, Hermosa Beach, CA 90254-4433 | 2020-10-25 |
| 1346849163 | Ambrosia Evon Steljes | Dental Hygienist | Building 13128 14th Street, Camp Pendleton, CA 92055-5221 | 2020-10-22 |
| 1427657261 | Julie Lynn March | Dental Hygienist | 19871 Mitscher Way Bldg 2495, San Diego, CA 92145-5103 | 2020-10-22 |
| 1386243327 | Leticia Isabel Alcantar | Dental Hygienist | Bldg 520448, Camp Pendleton, CA 92055 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
| City | ROUND MOUNTAIN |
| Zip Code | 96084 |
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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.