Kimberly Ann Perlot, EPDH, RDH

Primary specialty

Dental TherapistTaxonomy code 125J00000X

License

DT0010 Issued in OR

Practice address

1555 S Highway 97 Ste 102
Redmond, OR 97756-9652

Phone

(800) 525-6800

NPI assigned

Sep 24, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Capitol Dental Care, Inc.

  • Dental Clinic/Center
  • Salem, OR
  • NPI 1023286580
  NPD (past)
• Capitol Dental Group

  • Dental Clinic/Center
  • Salem, OR
  • NPI 1255889333
  NPD (past)

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1164073904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 HAWTHORNE AVE",
            "address_2": "SUITE #200",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97301",
            "telephone_number": "800-525-6800",
            "fax_number": "503-581-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 S HIGHWAY 97 STE 102",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977569652",
            "telephone_number": "800-525-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 SW 4th St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Madras",
            "state": "OR",
            "postal_code": "977411322",
            "country_code": "US",
            "telephone_number": "541-279-2382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERLOT",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "EPDH, RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "125J00000X",
            "taxonomy_group": "",
            "desc": "Dental Therapist",
            "state": "OR",
            "license": "DT0010",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OR",
            "license": "H7180",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristi Lynn Pentzer, CCC-SLP
• Clare Elena Perez, CRM
• Lawrence Joseph Perez
• Mary Lauren Periman, CRM
• Jessica Perkins, PT, DPT
• Donald Leon Peterson, OD
• Kelsey Rose Peterson, PA-C
• Leif Eric Petterson Jr., NP
• Nichole Petterson, FNP
• Hailey Pettijohn

• Dental Therapist in Redmond, OR
• Providers in Redmond, OR by specialty
• Dental Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.