MEDICARE: DENTAL HYGIENE PRACTICE OF CHERYLL KIDD, RDHAP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist

General Provider Information

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

Provider Business Mailing Address
First Line	:	9730 HURON ST
Second Line	:
City	:	SPRING VALLEY
State	:	CA
Zip	:	91977-5219
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9730 HURON ST
Second Line	:
City	:	SPRING VALLEY
State	:	CA
Zip	:	91977-5219
Country	:	US
Telephone Number	:	858-633-6995
Fax Number	:

Authorized Official
Title or Position	:	OWNER/RDHAP
Name	:	CHERYLL KIDD
Credential	:	RDHAP
Telephone Number	:	619-782-1285

Provider Enumeration Date	:	04/02/2026
Last Update Date	:	04/06/2026

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