Active NPI
Rebecca Lynn Sherrett, EFDA
- Dental Assistant
- Portland, OR
National Provider Identifier
1174028369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- Practice address
- 2930 NE Dekum St
Portland, OR 97211-6613 - Phone
- (503) 916-5908
- NPI assigned
- Mar 28, 2018
- 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 | OR | Primary |
Addresses
Primary practice location
2930 NE Dekum St
Portland, OR 97211-6613
Mailing address
16910 SE Naegeli Dr Apt 2
Portland, OR 97236-1386
Phone (503) 750-5891
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522195200000",
"number": "1174028369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16910 SE NAEGELI DR APT 2",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972361386",
"telephone_number": "503-750-5891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2930 NE DEKUM ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972116613",
"telephone_number": "503-916-5908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERRETT",
"first_name": "REBECCA",
"middle_name": "LYNN",
"credential": "EFDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-28",
"last_updated": "2018-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.