Active NPI
Lubov Maria Fultz
- Dental Hygienist
- Hillsboro, OR
National Provider Identifier
1154579092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- H5472
- Practice address
- 19075 NW Tanasbourne Dr Ste 300
Hillsboro, OR 97124-5802 - Phone
- (503) 531-1700
- Fax
- (503) 531-1704
- NPI assigned
- Sep 4, 2008
- 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 Hygienist | 124Q00000X | H5472 | OR | Primary |
Addresses
Primary practice location
19075 NW Tanasbourne Dr Ste 300
Hillsboro, OR 97124-5802
Mailing address
13470 SW Tulip CT
Beaverton, OR 97008-5017
Phone (503) 621-2806
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 |
|---|---|---|---|
| H5472 | OR | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220486400000",
"number": "1154579092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13470 SW TULIP CT",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970085017",
"telephone_number": "503-621-2806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19075 NW TANASBOURNE DR STE 300",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971245802",
"telephone_number": "503-531-1700",
"fax_number": "503-531-1704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULTZ",
"first_name": "LUBOV",
"middle_name": "MARIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-04",
"last_updated": "2008-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "OR",
"license": "H5472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.