Active NPI
Kunal Lalit Mansukhani, DMD
- Dentist
- Hillsboro, OR
National Provider Identifier
1184302788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D11829
- Practice address
- 2790 NE 106TH Ave Ste a
Hillsboro, OR 97124-7449 - Phone
- (503) 844-0700
- NPI assigned
- Jul 5, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | D11829 | OR | Primary |
Addresses
Primary practice location
2790 NE 106TH Ave Ste a
Hillsboro, OR 97124-7449
Mailing address
2222 NW Raleigh St Apt 630
Portland, OR 97210-3921
Phone (602) 300-0370
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 |
|---|---|---|---|
| D11829 | OR | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688515200000",
"number": "1184302788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2222 NW RALEIGH ST APT 630",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972103921",
"telephone_number": "602-300-0370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2790 NE 106TH AVE STE A",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971247449",
"telephone_number": "503-844-0700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANSUKHANI",
"first_name": "KUNAL",
"middle_name": "LALIT",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-05",
"last_updated": "2023-07-05",
"certification_date": "2023-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D11829",
"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 Jul 5, 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.