Jason Porter

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DE60936198 Issued in WA

Practice address

1721 E Lincoln Ave
Sunnyside, WA 98944-2478

Phone

(509) 837-7178

Fax

(509) 837-3117

NPI assigned

Jan 14, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ikdo State Street LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Garden City, ID
  • NPI 1932683752
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1003272444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 E LINCOLN AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442478",
            "telephone_number": "509-837-1778",
            "fax_number": "509-837-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 E LINCOLN AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442478",
            "telephone_number": "509-837-7178",
            "fax_number": "509-837-3117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9209 W State St",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837141737",
            "country_code": "US",
            "telephone_number": "208-388-1111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3289 N Towerbridge Way",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "83646",
            "country_code": "US",
            "telephone_number": "208-884-4466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-14",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0442000250",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "DE60936198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pine Family Practice LLC
• Mary Lou Pine, PA-C
• Pioneer Specialty Services, PLLC
• Planned Parenthood of Greater Washington & North Idaho (PPGWNI Sunnyside Health Center)
• Planned Parenthood of Greater Washington and North Idaho (Ppgwni)
• Aaron Price, D.O.
• Prosser Public Hospital District of Benton County (Prosser Memorial Health - Sunnyside Clinic)
• Qazi Mohsin
• Phillip Don Quigley, DMD
• Sean Quigley, DMD

• Orthodontics and Dentofacial Orthopedics Dentistry in Sunnyside, WA
• Providers in Sunnyside, WA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.