Individual provider Active NPI

Susanny Thenus, D.M.D

  • General Practice Dentistry
  • Scappoose, OR
National Provider Identifier
1275962599
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D9892 Issued in OR
Practice address
33454 Havlik Dr
Scappoose, OR 97056-3836
Phone
(503) 543-3136
NPI assigned
Nov 7, 2013
Last updated
Jan 9, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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 D9892 OR Primary

Addresses

Primary practice location

33454 Havlik Dr
Scappoose, OR 97056-3836

Mailing address

33454 Havlik Dr
Scappoose, OR 97056-3836
Phone (503) 543-3136

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151027000867 OR Order and Referring Only - DentistPractitioner - Dentist 6406165711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1275962599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33454 HAVLIK DR",
            "city": "SCAPPOOSE",
            "state": "OR",
            "postal_code": "970563836",
            "telephone_number": "503-543-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33454 HAVLIK DR",
            "city": "SCAPPOOSE",
            "state": "OR",
            "postal_code": "970563836",
            "telephone_number": "503-543-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THENUS",
        "first_name": "SUSANNY",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scappoose, OR

Sources for this page

Verify at the official NPI Registry.