Active NPI
Audrey Leigh Lutes, RDH
- Dental Hygienist
- Portland, OR
National Provider Identifier
1265880801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- H6505
- Practice address
- 3130 SE Division Street
Portland, OR 97202 - Phone
- (503) 515-2877
- NPI assigned
- May 24, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | H6505 | OR | Primary |
Addresses
Primary practice location
3130 SE Division Street
Portland, OR 97202
Mailing address
31920 Historic Columbia River Hwy
Troutdale, OR 97060-9377
Phone (503) 515-2877
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 |
|---|---|---|---|
| H6505 | OR | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464048000000",
"number": "1265880801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31920 HISTORIC COLUMBIA RIVER HWY",
"city": "TROUTDALE",
"state": "OR",
"postal_code": "970609377",
"telephone_number": "503-515-2877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3130 SE DIVISION STREET",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97202",
"telephone_number": "503-515-2877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTES",
"first_name": "AUDREY",
"middle_name": "LEIGH",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-24",
"last_updated": "2016-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "OR",
"license": "H6505",
"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 May 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.