Individual provider Active NPI

Alexandra Dahm

  • General Practice Dentistry
  • Kettering, OH
National Provider Identifier
1124408778
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.024520 Issued in OH
Practice address
1950 S Smithville Rd
Kettering, OH 45420-1446
Phone
(937) 253-9115
NPI assigned
Jun 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.024520 OH
General Practice Dentistry 1223G0001X 30.024520 OH Primary

Addresses

Primary practice location

1950 S Smithville Rd
Kettering, OH 45420-1446

Mailing address

1744 NE 42ND Ave
Portland, OR 97213-1537
Phone (503) 287-0072

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alexandra Dahm DDS LLC Dentist CurrentSince Oct 16, 2022 Accepting new patients
May M Chang General Practice PastSince Oct 16, 2022 Accepting new patients
Van Buren Dental PastSince Jan 15, 2023 Accepting new patients
Michael C Dahm General Practice Past Accepting new patients

Locations

1744 NE 42nd Ave
Portland, OR 97213
Phone (503) 287-0072

Organizations & group practices 4

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": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1124408778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1744 NE 42ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131537",
            "telephone_number": "503-287-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 S SMITHVILLE RD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454201446",
            "telephone_number": "937-253-9115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHM",
        "first_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-08",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.024520",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.024520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.