IndividualActive
Kellie Bergendahl, RDH
NPI 1053563619 · Dental Hygienist · Plummer, ID
Provider details
- NPI number
- 1053563619
- Entity type
- Individual
- Primary specialty
- Dental HygienistDental Providers
- Credential
- RDH
- Sex
- Female
- Sole proprietor
- No
- License
- DH2335 (ID)
Specialties & taxonomies
Dental Providers
Practice location
427 12th St
Plummer, ID 83851-4000
Phone: (208) 686-1931
Fax: (208) 686-5133
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 994
Coeur D Alene, ID 83816-0994
Registry dates
- Enumerated
- 2008-10-15
- Last updated
- 2019-09-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.