Individual provider Active NPI

Lillian H Harewood, DMD

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1043395221
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7118 Issued in OR
Practice address
833 SW 11TH Ave Ste 525
Portland, OR 97205-2131
Phone
(503) 228-2531
Fax
(503) 228-8229
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D7118 OR Primary

Addresses

Primary practice location

833 SW 11TH Ave Ste 525
Portland, OR 97205-2131

Mailing address

833 SW 11TH Ave Ste 525
Portland, OR 97205-2131
Phone (503) 228-2531

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170411000975 OR Order and Referring Only - DentistPractitioner - Dentist 7012293855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D7118ORMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: lharewood201358@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1043395221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 SW 11TH AVE STE 525",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052131",
            "telephone_number": "503-228-2531",
            "fax_number": "503-228-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 SW 11TH AVE STE 525",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052131",
            "telephone_number": "503-228-2531",
            "fax_number": "503-228-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAREWOOD",
        "first_name": "LILLIAN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.