Provider Demographics
NPI:1194699488
Name:LITTLE, MICHELLE LEE (RDH23156)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEE
Last Name:LITTLE
Suffix:
Gender:F
Credentials:RDH23156
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:LEE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RDH23156
Mailing Address - Street 1:20601 W PAOLI LN
Mailing Address - Street 2:
Mailing Address - City:WEIMAR
Mailing Address - State:CA
Mailing Address - Zip Code:95736
Mailing Address - Country:US
Mailing Address - Phone:530-637-4025
Mailing Address - Fax:
Practice Address - Street 1:20601 WEST PAOLI LANE
Practice Address - Street 2:
Practice Address - City:WEIMAR
Practice Address - State:CA
Practice Address - Zip Code:95736
Practice Address - Country:US
Practice Address - Phone:530-637-4025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23156124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist