Individual provider Active NPI

Somchanh Vongsoury

  • Dental Hygienist
  • Milwaukie, OR
National Provider Identifier
1184587073
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
H4529 Issued in OR
Practice address
10626 SE 75TH Ave
Milwaukie, OR 97222-2098
Phone
(503) 822-0117
NPI assigned
Dec 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X H4529 OR Primary

Addresses

Primary practice location

10626 SE 75TH Ave
Milwaukie, OR 97222-2098

Mailing address

10626 SE 75TH Ave
Milwaukie, OR 97222-2098
Phone (503) 822-0117

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

LicenseStateTypeSpecialty
H4529ORMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1765152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1184587073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10626 SE 75TH AVE",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972222098",
            "telephone_number": "503-822-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10626 SE 75TH AVE",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972222098",
            "telephone_number": "503-822-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONGSOURY",
        "first_name": "SOMCHANH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-08",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OR",
            "license": "H4529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.