KATHLEEN MARIE STACK RDH, MPH - NPI 1073793675 - Dental Hygienist in Willimantic, CT

Q: What is Kathleen Stack's NPI number?

The NPI number for Kathleen Stack is 1073793675. It was assigned to this individual provider in the NPPES registry on November 12, 2007.

Q: What is Kathleen Stack's specialty?

The primary specialty registered for this NPI is Dental Hygienist with taxonomy code 124Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Kathleen Stack was last updated on November 12, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.

On this page

About Kathleen Marie Stack Rdh, Mph NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHLEEN MARIE STACK RDH, MPH (NPI 1073793675) is an individual dental hygienist in Willimantic, Connecticut, licensed in Connecticut (007004) and active in the NPI registry since November 2007.

NPPES Registry Identity

NPI1073793675

Entity TypeIndividualFemale

Primary Taxonomy124Q00000X

Provider Legal NameKATHLEEN MARIE STACKCredential: RDH, MPH

Location Address1315 MAIN STWillimantic, CT 06226-1948

Mailing Address84 High St, #3Mystic, CT 06355-2439 · (860) 514-0968 · Fax (860) 423-4629

Phone(860) 450-7456

Fax(860) 423-4629

Sole ProprietorNo

Enumeration DateNovember 12, 2007

✔ NPI 1073793675 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDental HygienistDental Providers

Taxonomy Code124Q00000X

License✔ Licensed in CT · 007004

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.

1315 MAIN ST, Willimantic, CT 06226

Open in Google Maps ↗

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RICHARD L BRODY MD

Family Medicine

1315 MAIN ST, SUITE 2
WILLIMANTIC, CT 06226

Southeastern Connecticut Planning Region (860) 450-7471

NESTOR ENRIQUE TORRES MD

Family Medicine