Active NPI
Mandy Wengert, RDH
- Dental Hygienist
- Roseburg, OR
National Provider Identifier
1033581095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- H6587
- Practice address
- 2700 NW Stewart Pkwy
Roseburg, OR 97471-1281 - Phone
- (541) 677-4326
- NPI assigned
- Oct 29, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | H6587 | OR | Primary |
Addresses
Primary practice location
2700 NW Stewart Pkwy
Roseburg, OR 97471-1281
Mailing address
193 Oak Valley Loop
Winchester, OR 97495-8935
Phone (951) 533-5824
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H6587 | OR | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446076800000",
"number": "1033581095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "193 OAK VALLEY LOOP",
"city": "WINCHESTER",
"state": "OR",
"postal_code": "974958935",
"telephone_number": "951-533-5824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 NW STEWART PKWY",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974711281",
"telephone_number": "541-677-4326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENGERT",
"first_name": "MANDY",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-29",
"last_updated": "2015-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "OR",
"license": "H6587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.