Healthcare Provider Details

I. General information

NPI: 1508704743
Provider Name (Legal Business Name): KRISTI HAMBLIN PHELPS RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2026
Last Update Date: 03/21/2026
Certification Date: 03/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

488 S MOUNTAIN AVE
SPRINGERVILLE AZ
85938-5103
US

IV. Provider business mailing address

PO BOX 1896
EAGAR AZ
85925-1896
US

V. Phone/Fax

Practice location:
  • Phone: 928-245-6662
  • Fax:
Mailing address:
  • Phone: 928-245-6662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH04151
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: