Basic Information
| Provider Information | |||||||||
| NPI: | 1083369193 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ESTEP | ||||||||
| FirstName: | KIRSTEN | ||||||||
| MiddleName: | JEAN | ||||||||
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| Credential: | BSW, RDH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15066 GRINDSTONE LN | ||||||||
| Address2: | |||||||||
| City: | FULKS RUN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228302230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8142792794 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1380 LITTLE SORRELL DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228017372 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5402363688 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2022 | ||||||||
| LastUpdateDate: | 02/16/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 124Q00000X | 0402208072 | VA | Y | Dental Providers | Dental Hygienist |
No ID Information.