CRYSTAL MAE SHEPHERD (NPI# 1538550728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538550728 |
| Entity Type | Individual |
| Full Name | CRYSTAL MAE SHEPHERD |
| Credential | RDH |
| Practice Address |
3165 E Spaulding Ave Apt 101 Pueblo CO 81008-2243 |
| Mailing Address |
3165 E. Spauilding Ave Apt 101 Pueblo CO 81008 |
| Practice Telephone | 3073996186 |
| Mailing Telephone | 3073996186 |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2015-02-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 002023652 | CO | Dental Providers |
| Street Address |
3165 E SPAULDING AVE APT 101 |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-2243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164058913 | Healthone Clinic Services - Oncology Hematology LLC | Internal Medicine | 3678 Parker Blvd, Pueblo, CO 81008 | 2020-03-12 |
| 1073026423 | Carmel Community Living Corporation | Respite Care | 2003 Northmoor Terrace, Suite 100, Pueblo, CO 81008 | 2017-11-08 |
| 1568987121 | Hannah Vivian Roadruck | Pharmacist | 4200 Dillon Dr., Pueblo, CO 81008 | 2017-08-04 |
| 1184170425 | Brett Burana | Dentist | 729 Us-50, Pueblo, CO 81008 | 2016-08-28 |
| 1760832885 | Irby Dental Cottage | Dental Hygienist | 2099 West St # 50, Suite 180, Pueblo, CO 81008 | 2016-06-20 |
| 1649624362 | Curley Peak Dentistry Pllc | Dentist | 1640 W Fortino Blvd, Pueblo, CO 81008 | 2016-04-19 |
| 1336507847 | Kyle Tipton | Nurse Anesthetist, Certified Registered | 4741 Eagleridge Circle, 206, Pueblo, CO 81008 | 2016-01-29 |
| 1407211931 | Center At Park West, LLC | Skilled Nursing Facility | 3727 Parker Blvd., Pueblo, CO 81008 | 2015-12-29 |
| 1417327461 | Nicole Betts | Registered Nurse | 1310 Fortino Blvd Ste D, Pueblo, CO 81008 | 2015-10-02 |
| 1437578028 | Pueblo Modern Dentistry and Orthodontics, LLP | Dentist | 727 Us Hwy 50 West, Pueblo, CO 81008 | 2014-04-10 |
| Find all providers in zip 81008 | ||||
| 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 |
|---|---|---|---|---|
| 1124533393 | Lauren Stewart | Dental Hygienist | 2824 7th Ave, Pueblo, CO 81003-1625 | 2017-12-09 |
| 1528593167 | Melissa Dasher | Dental Hygienist | 1292 Zinno Blvd, Pueblo, CO 81006 | 2017-04-20 |
| 1760832885 | Irby Dental Cottage | Dental Hygienist | 2099 West St # 50, Suite 180, Pueblo, CO 81008 | 2016-06-20 |
| 1144695917 | Megan Nicole Passig | Dental Hygienist | 2920 Thornberry Ln, Pueblo, CO 81005-5110 | 2015-12-04 |
| 1790171429 | Dr. Robert C. Davis | Dental Hygienist | 902 West 29th Street, Pueblo, CO 81008-1159 | 2015-04-09 |
| 1720482607 | Jeanne Graves | Dental Hygienist | 2099 W. Us Hwy 50, Suite #180, Pueblo, CO 81008-1673 | 2014-10-21 |
| 1376947481 | Linda Capito | Dental Hygienist | 36197 Daniel Rd, Pueblo, CO 81006-9430 | 2014-10-17 |
| 1386079465 | Bernice Martinez | Dental Hygienist | 1700 N Salem Ave Ste B, Pueblo, CO 81001-2846 | 2013-09-09 |
| 1356780167 | Rita Sebastiana Ohrdorf | Dental Hygienist | 1000 W 6th St Ste V, Pueblo, CO 81003-2378 | 2013-06-14 |
| 1073862306 | Maryellen Blasing | Dental Hygienist | 106 La Vista Rd, Pueblo, CO 81005-2617 | 2012-08-31 |
| Find all providers in PUEBLO | ||||
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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.