Individual provider Active NPI

Sareena Gillani, DMD

  • Dentist
  • Portland, OR
National Provider Identifier
1275026361
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D11344 Issued in OR
Practice address
2038 Lloyd Ctr Ste H317
Portland, OR 97232-1309
Phone
(503) 897-1592
NPI assigned
Jun 13, 2018
Last updated
Sep 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X D11344 OR Primary

Addresses

Primary practice location

2038 Lloyd Ctr Ste H317
Portland, OR 97232-1309

Mailing address

1430 NW Hoyt St Apt 525
Portland, OR 97209-2288

Other practice location 1

Harlem Hospital Center Department of Dentistry
15 W 136th Street Mezzanine Fl Room M-111
New York, NY 10037
Phone (212) 939-1000

Other practice location 2

2550 Citywest Blvd Ste 300
Houston, TX 77042-4084
Phone (281) 769-4169

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
D11344ORMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Dental of Westchase PLLC Dentist CurrentSince May 21, 2023 Accepting new patients

Locations

2550 Citywest Blvd
Ste 300
Houston, TX 77042
Phone (281) 769-4169

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1275026361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 NW HOYT ST APT 525",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2038 LLOYD CTR STE H317",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321309",
            "telephone_number": "503-897-1592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Harlem Hospital Center Department of Dentistry",
            "address_2": "15 W 136th Street Mezzanine Fl Room M-111",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10037",
            "country_code": "US",
            "telephone_number": "212-939-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2550 Citywest Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770424084",
            "country_code": "US",
            "telephone_number": "281-769-4169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLANI",
        "first_name": "SAREENA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11344",
            "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 Sep 30, 2020; 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.