Individual provider Active NPI

Shauna Dale Sonoda, RDH

  • Dental Hygienist
  • Portland, OR
National Provider Identifier
1104252402
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
H6496 Issued in OR
Practice address
12000 SW 49TH Ave
Portland, OR 97219
Phone
(866) 922-1010
NPI assigned
Sep 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X H6496 OR Primary

Addresses

Primary practice location

12000 SW 49TH Ave
Portland, OR 97219

Mailing address

16630 SW Heceta CT
Beaverton, OR 97007-7819
Phone (503) 348-8684

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

LicenseStateTypeSpecialty
H6496ORMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1104252402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16630 SW HECETA CT",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970077819",
            "telephone_number": "503-348-8684",
            "fax_number": "503-649-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 SW 49TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97219",
            "telephone_number": "866-922-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONODA",
        "first_name": "SHAUNA",
        "middle_name": "DALE",
        "name_prefix": "Ms.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-18",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OR",
            "license": "H6496",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.