Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1073793675 Individual Practitioner Female Practitioner

Kathleen Marie Stack , RDH, MPH

Dental Hygienist • Willimantic, CT

Professional Overview & Biography Verified Profile Summary

Kathleen Stack, RDH, MPH is a registered healthcare professional specializing in Dental Hygienist in Willimantic, CT. Practice services are available at 1315 MAIN ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1315 Main St

Willimantic, CT 062261948

Telephone 8604507456
Fax 8604234629

Specialty Benchmarks & Practice Insights

Comparative analytics for Dental Hygienist in Willimantic, CT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
9 Specialists

Practicing in Willimantic, CT (428 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dental Hygienist Primary Specialty

NUCC Taxonomy Code: 124Q00000X

State License CT 007004

An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Dr. Michael Goodman , DDS

Dentist - Pediatric Dentistry

NPI 1043275548

Doctor of Dental Surgery

NPI 1063495216

Registered Pharmacist

Pamela Young , RDH

Dental Hygienist

NPI 1093794323

Registered Dental Hygienist

NPI 1376513184

Doctor of Dental Medicine

Dr. Mashid Hedayati , DDS

Dentist - Dental Public Health

NPI 1912065632

Doctor of Dental Surgery

Cheryl Ceniglio , RDH

Dental Hygienist

NPI 1932389210

Registered Dental Hygienist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active November 12, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location November 12, 2007

Registered at 1315 MAIN ST, WILLIMANTIC, CT 062261948 (Tel: 8604507456)

📍
Updated Business Mailing Address November 12, 2007

Registered at 84 HIGH ST, #3, MYSTIC, CT 063552439 (Tel: 8605140968)

👤
Provider Name / Credentials Updated November 12, 2007

Recorded as KATHLEEN STACK, RDH, MPH

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 12, 2007

Dental Hygienist (License #007004 in CT)

🟢
Initial NPI Registration & Enumeration November 12, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1073793675
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 12, 2007
Last Update: November 12, 2007
Sole Proprietor: No

Mailing Address

84 High St, #3

Mystic, CT 063552439

Phone: 8605140968

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.