Nicole Therese Kemena, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D10139 Issued in OR

Practice address

600 NE 8TH St Ste 210
Gresham, OR 97030-7341

Phone

(503) 988-4900

NPI assigned

Sep 15, 2012

Sex

Female

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 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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1347667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1063762151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 NE 8TH ST STE 210",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307341",
            "telephone_number": "503-988-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NE 8TH ST STE 210",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307341",
            "telephone_number": "503-988-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMENA",
        "first_name": "NICOLE",
        "middle_name": "THERESE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-15",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "61914",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valyn Lee Keith-Jackson, CADC 1
• Arianne Keller
• Matthew Evan Keller, CADC I APPLICANT
• Julienne Kelly
• Paul Gerard Kelly, MPT
• Afton Kendell, L.M.T.
• Cristina Pellicano Kennedy, D.M.D.
• Marshal Terrance Kennedy, DPM
• Nathan Kennelly, CRM, CADC R
• Ronald L Kerns, O.D.

• Dentist in Gresham, OR
• Providers in Gresham, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.

Verify at the official NPI Registry.