Provider Demographics
NPI:1538825047
Name:HILL, LASHONDA NICOLE (RDH)
Entity type:Individual
Prefix:
First Name:LASHONDA
Middle Name:NICOLE
Last Name:HILL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 S FM 116
Mailing Address - Street 2:APT 3206
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-3605
Mailing Address - Country:US
Mailing Address - Phone:270-304-6531
Mailing Address - Fax:
Practice Address - Street 1:9440 BATTALION AVENUE
Practice Address - Street 2:
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-287-6484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3693124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist