Individual provider Active NPI

Alicia Joy Plumb, D.D.S

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1255425294
Registry record updated Mar 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7665 Issued in OR
Practice address
3653 SE 34TH Ave
Portland, OR 97202-3034
Phone
(503) 988-4410
Fax
(503) 988-5642
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2014

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 D7665 OR Primary

Addresses

Primary practice location

3653 SE 34TH Ave
Portland, OR 97202-3034

Mailing address

2025 SE Caruthers St
#7
Portland, OR 97214-5465
Phone (971) 221-8847

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151125001007 OR Order and Referring Only - Other (Non-Physician) 2163722059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: aplumb8347@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396051200000",
    "number": "1255425294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SE CARUTHERS ST",
            "address_2": "#7",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972145465",
            "telephone_number": "971-221-8847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3653 SE 34TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023034",
            "telephone_number": "503-988-4410",
            "fax_number": "503-988-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUMB",
        "first_name": "ALICIA",
        "middle_name": "JOY",
        "name_prefix": "Ms.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2014-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.