Individual provider · Type 1 NPI

Kellie Renee Bergendahl, RDH

Dental Hygienist · Plummer, ID

NPI number 1053563619 Active

Practice location

427 12th St
Plummer, ID 83851-4000

Call (208) 686-1931 Map

Fax (208) 686-5133

Mailing address

PO Box 994
Coeur D Alene, ID 83816-0994

Specialties and licenses

TaxonomyCodeLicense
Dental Hygienist Primary 124Q00000XDH2335 (ID)

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…

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About NPI 1053563619

Kellie Renee Bergendahl, RDH's National Provider Identifier is 1053563619, issued on Oct 15, 2008. The primary taxonomy on file is Dental Hygienist (124Q00000X), and the practice location is in Plummer, ID. The record was last updated on Sep 23, 2019.