Individual
MRS. KIERESTEN R ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
459 S CHINA LAKE BLVD STE D, RIDGECREST, CA 93555-4669
(760) 428-8837
Mailing address
459 S CHINA LAKE BLVD STE D, RIDGECREST, CA 93555-4669
(760) 608-4102
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1001
CA
125K00000X
Advanced Practice Dental Therapist
Primary
1001
CA
Other
Enumeration date
08/10/2023
Last updated
03/11/2026
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