Monisha Gagneja, B.D.S

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DE00010814 Issued in WA

Practice address

830 NE 47TH Ave
Providence Child Centre -Speciality Dent
Portland, OR 97213-2212

Phone

(503) 215-1060

NPI assigned

Oct 30, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312156800000",
    "number": "1184803751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16604 SE FISHER DR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986831417",
            "telephone_number": "360-433-2997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 NE 47TH AVE",
            "address_2": "PROVIDENCE CHILD CENTRE -SPECIALITY DENT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132212",
            "telephone_number": "503-215-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNEJA",
        "first_name": "MONISHA",
        "name_prefix": "Dr.",
        "credential": "B.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-30",
        "last_updated": "2011-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE00010814",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D9549",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184803751",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214020",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yomiyu Gafesu
• Shawn Gafford, PHARM.D.
• Christopher Ryan Gage
• Katharine Gage, PMHNP
• Carole Gaglione, NP
• Jack L Gagnon
• Lawrence Paul Gagnon, DMD
• Lisa Rose Ariana Gagnon
• Molly Gagnon, COTA
• Diane Marie Gahan, RPH

• Pediatric Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• Pediatric Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; 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.