Jay Preston Malmquist, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D4642 Issued in OR

Practice address

5415 SW Westgate Dr
Suite #L-7
Portland, OR 97221-2409

Phone

(503) 292-8824

Fax

(503) 297-7810

NPI assigned

Aug 29, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 11, 2016 through Apr 11, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Oregon Anesthesiology Group PC

  • Anesthesiology Physician
  • Portland, OR
  • NPI 1477527786
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275641284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 SW WESTGATE DR",
            "address_2": "SUITE #L-7",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212409",
            "telephone_number": "503-292-8824",
            "fax_number": "503-297-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 SW WESTGATE DR",
            "address_2": "SUITE #L-7",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212409",
            "telephone_number": "503-292-8824",
            "fax_number": "503-297-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALMQUIST",
        "first_name": "JAY",
        "middle_name": "PRESTON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D4642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rionna Malloy
• Alexandra Mally
• Bojan Lee Malmin, MD
• Catherine Malmin, CRNA
• Rachel Malmon, MS, CCC-SLP
• Betsy Ann Malolepsy
• Brianne Malone
• Celeste Ariel Malone
• Meribeth Ester Malone
• Sarah Margaret Malone, PA-C

• Oral and Maxillofacial Surgery (Dentist) in Portland, OR
• Providers in Portland, OR by specialty
• Oral and Maxillofacial Surgery (Dentist) in Oregon

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.