Active NPI
Asela Agtay Wells
- Dental Assistant
- Beaverton, OR
National Provider Identifier
1144866591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 116705
- Practice address
- 4855 SW Western Ave
Beaverton, OR 97005-3460 - Phone
- (503) 626-4148
- NPI assigned
- Nov 20, 2019
- Last updated
- Nov 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 116705 | OR | Primary |
Addresses
Primary practice location
4855 SW Western Ave
Beaverton, OR 97005-3460
Mailing address
13440 SW Castlewood St
Beaverton, OR 97005-1203
Phone (971) 344-0288
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
| License | State | Type | Specialty |
|---|---|---|---|
| 116705 | OR | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574208000000",
"number": "1144866591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13440 SW CASTLEWOOD ST",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970051203",
"telephone_number": "971-344-0288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4855 SW WESTERN AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970053460",
"telephone_number": "503-626-4148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "ASELA",
"middle_name": "AGTAY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-20",
"last_updated": "2019-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "OR",
"license": "116705",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.