KELLY PICKTON


Address: 554 Keily St Bumed Ccp Directorate, Jacksonville, FL 32212
Phone: 7579531897

KELLY PICKTON (NPI# 1497185060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497185060
Entity Type Individual
Full Name KELLY PICKTON
Practice Address 554 Keily St Bumed Ccp Directorate
Jacksonville
FL 32212
Practice Telephone 7579531897
Enumeration Date 2013-11-19
Last Update Date 2013-11-19
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 124Q00000X Dental Hygienist 20996 FL Dental Providers

Office Location

Street Address 554 KEILY ST BUMED CCP DIRECTORATE
City JACKSONVILLE
State FL
Zip Code 32212

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1952911752 Jeff Woohyeok Chang Dentist 964 Ajax Street, Jacksonville, FL 32212 2020-08-06
1518484427 Amy Kathryn Lee Student in an Organized Health Care Education/Training Program Bumed, Centralized Credential & Privileging Directorate, 554 Keily Street, Jacksonville, FL 32212 2017-08-23
1659827970 Noah Fixelle Dentist Bureau of Med and Surg Ccpd, 554 Keily Street, Jacksonville, VA 32212 2016-08-28
1972953339 Colin Kenneth Kelly General Practice Bureau of Medicine & Surgery Detachment, Nas Jacksonville, Building 554, Jacksonville, FL 32212 2016-06-16
1912382359 Caitlyn Brooke Hoysock Dentist 554 Keiley Street, Bureau of Medicine and Surgery - Credentials, Jacksonville, FL 32212 2015-07-28
1285017418 John Alexander Ruch Dentist 554 Keily Street Bureau of Med and Surg Ccpd, Jacksonville, FL 32212 2015-07-07
1407238561 Amanda Mona Lau Student in an Organized Health Care Education/Training Program 554 Kelly Street, Attn Centralized Credentialing, Bureau of Medicine and Surgery, Jacksonville, FL 32212 2015-06-25
1063894715 Heather Dehaan Family Medicine 554 Kelly Street Bureau of Medicine and Surgery, Attention: Centralized Credentialing & Privileging Dire, Jacksonville, FL 32212 2015-06-18
1912389677 Catherine Garcia Student in an Organized Health Care Education/Training Program 554 Kelly St, Credentialing & Privileging Directorate, Bureau of Medicine & Surgery, Attention: Centralized, Jacksonville, FL 32212 2015-06-18
1255712675 James Robert Benson Dentist 734 Keily Street, Bumed, Jacksonville, FL 32212 2015-06-11
Find all providers in zip 32212

Taxonomy Information

Taxonomy Code 124Q00000X
Grouping Dental Providers
Classification Dental Hygienist

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1962012328 Melody Jean Garcia Dental Hygienist Navy Medicene Support Command : Medical Staff Services, Bldg H, 2005 Knight Lane, Jacksonville, FL 32221-0140 2020-07-31
1659918985 Iris E Fernandezregis Dental Hygienist Medical Staff Svcs, Bldg H 2005 Knight Lane, Jacksonville, FL 32212-0140 2019-12-05
1508341694 Tommie Janae Kell Dental Hygienist 235 W Main St Fl 2, Jacksonville, OR 97530-9278 2018-09-25
1457759722 Yue Wang Dental Hygienist 554 Keily Street - Bureau of Medicine and Surgery, Credentialing and Privileging, Jacksonville, FL 32212 2014-12-18
1295132017 Trupti Patel Dental Hygienist 554 Keily St - Bureau of Medicine and Surgery, Certralized Credentials, Jacksonville, FL 32212 2014-11-21
1073866679 Aubrie Leigh Tanner Dental Hygienist 7933 Baymeadows Way Ste 5, Jacksonville, FL 32256-7514 2012-10-19
1336492024 Donna Mahacek Dental Hygienist 2764 Sebastian Ct, Jacksonville, FL 32224-2896 2012-10-18
1457518755 Patricia Louise Jakubec Dental Hygienist 13226 Moby Dick Dr W, Jacksonville, FL 32218-2891 2008-05-22
1659464055 Ernesto Aleniado Soberano Dental Hygienist 301 Preston Rd, Jacksonville, NC 28540-5656 2006-09-30
1629616636 Maria Kiana Rogers Dental Hygienist Navy Medicine Support Command Attn: Medical Staff Svcs, Bldg H 2005 Knight Lane, Jacksonville, FL 32212-0140 2019-12-20
Find all providers in JACKSONVILLE

Competitor

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City JACKSONVILLE
Zip Code 32212

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Dataset Information

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.

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