=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164399838
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMILY ROSE DRESSER RDH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/18/2025
-----------------------------------------------------
Last Update Date | 10/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 959 MYRTLE AVE
-----------------------------------------------------
City | EUREKA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95501-1219
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-442-7078
-----------------------------------------------------
Fax | 707-442-7298
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1275 8TH ST
-----------------------------------------------------
City | ARCATA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95521-5770
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-826-8633
-----------------------------------------------------
Fax | 707-826-8638
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 124Q00000X
-----------------------------------------------------
Taxonomy Name | Dental Hygienist
-----------------------------------------------------
License Number | 30490
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------