Individual provider Active NPI

Michael Yaremko III, DMD

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1255352993
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5016 Issued in OR
Practice address
2517 SE 179TH Ave
Portland, OR 97236-1035
Phone
(503) 761-4001
Fax
(503) 761-0559
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5016 OR Primary

Addresses

Primary practice location

2517 SE 179TH Ave
Portland, OR 97236-1035

Mailing address

2517 SE 179TH Ave
Portland, OR 97236-1035
Phone (503) 761-4001

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
5016ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Yaremko Dmdpc General Practice Past Accepting new patients
Ryan Carpenter DMD PC General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255352993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2517 SE 179TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972361035",
            "telephone_number": "503-761-4001",
            "fax_number": "503-761-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2517 SE 179TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972361035",
            "telephone_number": "503-761-4001",
            "fax_number": "503-761-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAREMKO",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "5016",
            "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 Jul 8, 2007; 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.