Jacqueline Gambee

Primary specialty

DentistTaxonomy code 122300000X

License

D10623 Issued in OR

Practice address

133 E Main St
Carlton, OR 97111

Phone

(503) 852-7147

NPI assigned

Apr 19, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Carlton Dental

  • General Practice Dentistry
  • Carlton, OR
  • NPI 1295031870
  NPD (past)
• Carlton Dental, LLC

  • General Practice Dentistry
  • Carlton, OR
  • NPI 1275912560
  NPD (past)

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1134573843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E MAIN ST",
            "city": "CARLTON",
            "state": "OR",
            "postal_code": "97111",
            "telephone_number": "503-852-7147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Lancaster Dr NE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973051223",
            "country_code": "US",
            "telephone_number": "503-370-4843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMBEE",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-19",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL DENTIST",
            "identifier": "D10623",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carlton Dental
• Carlton Dental, LLC
• Carlton Wellness Studio LLC
• Jeremiah W Cook, LMT
• Jillian M Crossgrove, BSM, CPM, LDM
• Jennifer Kelley
• Llama a Un Amigo
• Med Info Services, LLC
• Linda Meloche, N.D., L.AC
• Mark A. Miller, DMD

• Dentist in Carlton, OR
• Providers in Carlton, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.