Healthcare Provider Details

I. General information

NPI: 1457292740
Provider Name (Legal Business Name): DENTAL HYGIENE PRACTICE OF CHERYLL KIDD, RDHAP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9730 HURON ST
SPRING VALLEY CA
91977-5219
US

IV. Provider business mailing address

9730 HURON ST
SPRING VALLEY CA
91977-5219
US

V. Phone/Fax

Practice location:
  • Phone: 858-633-6995
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State

VIII. Authorized Official

Name: CHERYLL KIDD
Title or Position: OWNER/RDHAP
Credential: RDHAP
Phone: 619-782-1285