Individual provider Active NPI

Jocelyn Limerick, DMD

  • Dentist
  • Salem, OR
National Provider Identifier
1124689997
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D12074 Issued in OR
Practice address
255 Lancaster Dr NE
Salem, OR 97301-5155
Phone
(503) 576-8350
NPI assigned
Jun 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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 D-5056 ID
Dentist 122300000X D12074 OR Primary

Addresses

Primary practice location

255 Lancaster Dr NE
Salem, OR 97301-5155

Mailing address

PO Box 190
Toppenish, WA 98948-0190
Phone (509) 865-2395

Other practice location 1

11136 Moss Ln
Nampa, ID 83651-8015
Phone (208) 466-0515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20191030003306 ID Order and Referring Only - DentistPractitioner - Dentist 4486986023

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9401 Southwest Fwy
Houston, TX 77074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D12074ORMDDentist
109628TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1124689997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989480190",
            "telephone_number": "509-865-2395",
            "fax_number": "509-865-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973015155",
            "telephone_number": "503-576-8350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11136 Moss Ln",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836518015",
            "country_code": "US",
            "telephone_number": "208-466-0515",
            "fax_number": "208-442-5338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIMERICK",
        "first_name": "JOCELYN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-5056",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D12074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.