Active NPI
Frank James Foreman, DDS
- Pediatric Dentistry
- Gresham, OR
National Provider Identifier
1013015452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- D10202
- Practice address
- 387 NE 223Rd Ave
Gresham, OR 97030-8554 - Phone
- (503) 625-2538
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DE00007037 | WA | |
| Pediatric Dentistry | 1223P0221X | D10202 | OR | Primary |
Addresses
Primary practice location
387 NE 223Rd Ave
Gresham, OR 97030-8554
Mailing address
387 NE 223Rd Ave
Gresham, OR 97030-8554
Phone (503) 625-2538
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160923001066 | OR | Order and Referring Only - Other (Physician) | 4688961386 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D10202 | OR | MD | Pediatric Dentist |
| DE00007037 | WA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452038400000",
"number": "1013015452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "387 NE 223RD AVE",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970308554",
"telephone_number": "503-625-2538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "387 NE 223RD AVE",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970308554",
"telephone_number": "503-625-2538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOREMAN",
"first_name": "FRANK",
"middle_name": "JAMES",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2016-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "WA",
"license": "DE00007037",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OR",
"license": "D10202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; 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.