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General NPI Number Information
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NPI Number | 1225829427
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Entity Type | Individual
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Provider Name | KELLY DEPNER RDH
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Gender | Female
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 6994 EL CAMINO REAL STE 108
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City | CARLSBAD
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State | CA
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Zip | 92009-4117
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Country | US
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Telephone | 760-431-7711
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Fax |
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Provider Business Mailing Address
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Address Line | 1651 S JUNIPER ST UNIT 145
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City | ESCONDIDO
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State | CA
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Zip | 92025-6165
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Country | US
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Telephone | 760-520-5013
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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 | 30578
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License Number State | CA
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