Active NPI
Jeffrey E Ulmer, DMD
- Dentist
- Portland, OR
National Provider Identifier
1083770002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D8318
- Practice address
- 405 SE 133Rd Ave
Portland, OR 97233-1809 - Phone
- (855) 433-6825
- NPI assigned
- Dec 28, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D8318 | OR | Primary |
Addresses
Primary practice location
405 SE 133Rd Ave
Portland, OR 97233-1809
Mailing address
6950 NE Campus Way
Hillsboro, OR 97124-5611
Phone (503) 952-2125
Other practice location 1
3490 Lancaster Dr NE
Salem, OR 97305
Phone (503) 540-9041
Other practice location 2
6902 SE Lake Rd Ste 200
Milwaukie, OR 97267-2148
Phone (855) 433-6825
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 299880 | Other | OR | DMAP |
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 |
|---|---|---|---|
| D8318 | OR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willamette Dental Group | Dentist | Past | 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.
-
- Dentist
- Salem, OR
- NPI 1992182026
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688515200000",
"number": "1083770002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6950 NE CAMPUS WAY",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971245611",
"telephone_number": "503-952-2125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 SE 133RD AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972331809",
"telephone_number": "855-433-6825"
}
],
"practiceLocations": [
{
"address_1": "3490 Lancaster Dr NE",
"address_purpose": "LOCATION",
"city": "Salem",
"state": "OR",
"postal_code": "97305",
"country_code": "US",
"telephone_number": "503-540-9041",
"fax_number": "503-540-9056",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6902 SE Lake Rd Ste 200",
"address_purpose": "LOCATION",
"city": "Milwaukie",
"state": "OR",
"postal_code": "972672148",
"country_code": "US",
"telephone_number": "855-433-6825",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ULMER",
"first_name": "JEFFREY",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-28",
"last_updated": "2023-07-05",
"certification_date": "2023-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D8318",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMAP",
"identifier": "299880",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.