Provider Demographics
NPI:1619776671
Name:DAWSON, KRISTY NICOLE (DENTAL HYGENTIST)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:NICOLE
Last Name:DAWSON
Suffix:
Gender:F
Credentials:DENTAL HYGENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8487 S SCENIC HWY
Mailing Address - Street 2:
Mailing Address - City:BLAND
Mailing Address - State:VA
Mailing Address - Zip Code:24315-4691
Mailing Address - Country:US
Mailing Address - Phone:276-688-4711
Mailing Address - Fax:276-688-4712
Practice Address - Street 1:8487 S SCENIC HWY
Practice Address - Street 2:
Practice Address - City:BLAND
Practice Address - State:VA
Practice Address - Zip Code:24315-4691
Practice Address - Country:US
Practice Address - Phone:276-688-4711
Practice Address - Fax:276-688-4712
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0402004612124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist