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NPI 1194699488

NPI 1194699488 : MICHELLE LEE LITTLE RDH23156 : WEIMAR, CA

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General NPI Number Information
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    NPI Number           |    1194699488
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    Entity Type          |    Individual 
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    Provider Name        |    MICHELLE LEE LITTLE RDH23156
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/01/2025
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    Last Update Date     |    10/01/2025
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Provider Practice Location Address
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    Address Line         |    20601 WEST PAOLI LANE 
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    City                 |    WEIMAR
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    State                |    CA
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    Zip                  |    95736
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    Country              |    US
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    Telephone            |    530-637-4025
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    20601 W PAOLI LN 
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    City                 |    WEIMAR
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    State                |    CA
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    Zip                  |    95736
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    Country              |    US
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    Telephone            |    530-637-4025
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    124Q00000X
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    Taxonomy Name        |    Dental Hygienist
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    License Number       |    23156
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    License Number State |    CA
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