Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
STEPHANIE ANDREYA JACKSON, RDH
ActiveDental Hygienist · PROVO, UT
Registration Details
- NPI Number
- 1205045796
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 21, 2007 (18.927964944311 yrs)
- Last Updated
- Jul 8, 2007
- Licenses
-
13208 (TX)5908 (AZ)5655443-0701 (UT)
Practice Information
- Address
-
801 CRESTVIEW AVEPROVO, UT, 846044777Browse UT providers · Browse ZIP 84604
- Phone
- 8012229354
- Primary Specialty
-
Dental Hygienist
124Q00000X
- Additional Specialty
- Dental Hygienist
- Additional Specialty
- Dental Hygienist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.