Individual provider Active NPI

Rania Anne Khouri, DMD

  • Dentist
  • Wilsonville, OR
National Provider Identifier
1053294736
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D12229 Issued in OR
Practice address
30040 SW Boones Ferry Rd Ste 20
Wilsonville, OR 97070-8910
Phone
(503) 682-4500
NPI assigned
Jul 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D12229 OR Primary

Addresses

Primary practice location

30040 SW Boones Ferry Rd Ste 20
Wilsonville, OR 97070-8910

Mailing address

11064 SE Scotts Summit CT
Happy Valley, OR 97086-9104
Phone (503) 915-3053

Other practice location 1

11064 SE Scotts Summit Ct
Happy Valley, OR 97086-9104
Phone (503) 915-3053

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
I20251008001835 OR Order and Referring Only - DentistPractitioner - Dentist 1153828983

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D12229ORMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Wilsonville Smiles PC PastSince Aug 3, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1753747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1053294736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11064 SE SCOTTS SUMMIT CT",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970869104",
            "telephone_number": "503-915-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30040 SW BOONES FERRY RD STE 20",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970708910",
            "telephone_number": "503-682-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11064 SE Scotts Summit Ct",
            "address_purpose": "LOCATION",
            "city": "Happy Valley",
            "state": "OR",
            "postal_code": "970869104",
            "country_code": "US",
            "telephone_number": "503-915-3053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHOURI",
        "first_name": "RANIA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-29",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D12229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilsonville, OR

Sources for this page

Verify at the official NPI Registry.