Individual provider Active NPI

Natasha Bramley, DMD

  • Pediatric Dentistry
  • Portland, OR
National Provider Identifier
1083884282
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D9760 Issued in OR
Practice address
10535 NE Glisan St Ste 301
Portland, OR 97220-4077
Phone
(503) 213-1257
Fax
(215) 747-6907
NPI assigned
Mar 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS036958 PA
Pediatric Dentistry 1223P0221X D9760 OR Primary

Addresses

Primary practice location

10535 NE Glisan St Ste 301
Portland, OR 97220-4077

Mailing address

5828 B Market Street
2ND Floor
Philadelphia, PA 19139-3114
Phone (215) 747-6901

Other identifiers 1

IdentifierTypeStateIssuer
500651153MedicaidOR

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
I20151027000368 OR Order and Referring Only - DentistPractitioner - Dentist 8426367830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS036958PAMDGeneral Practice Dentistry
D9760ORMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Kids Smiles General Practice 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.

NPI Registry JSON

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1083884282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5828 B MARKET STREET",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393114",
            "telephone_number": "215-747-6901",
            "fax_number": "215-747-6907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 NE GLISAN ST STE 301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204077",
            "telephone_number": "503-213-1257",
            "fax_number": "215-747-6907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAMLEY",
        "first_name": "NATASHA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-04",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS036958",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D9760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500651153",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.