Individual provider Active NPI

Meredith Leigh Dugoni, D.M.D., M.S.D

  • Dentist
  • Beaverton, OR
National Provider Identifier
1124401385
Registry record updated Jul 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0442000249 Issued in VA
Practice address
4925 SW Griffith Dr
Beaverton, OR 97005-2923
Phone
(855) 433-6825
NPI assigned
Jul 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0442000249 VA Primary

Addresses

Primary practice location

4925 SW Griffith Dr
Beaverton, OR 97005-2923

Mailing address

6950 NE Campus Way
Hillsboro, OR 97124-5611

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
I20180302002309 OR Order and Referring Only - DentistPractitioner - Dentist 8820359094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0442000249VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500336000000",
    "number": "1124401385",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4925 SW GRIFFITH DR",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052923",
            "telephone_number": "855-433-6825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGONI",
        "first_name": "MEREDITH",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2017-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0442000249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.