Individual provider Active NPI

Vicki J Reichlein, DMD

  • General Practice Dentistry
  • Gresham, OR
National Provider Identifier
1285795690
Registry record updated Nov 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7358 Issued in OR
Practice address
2039 NE Burnside Rd
Gresham, OR 97030-7998
Phone
(503) 669-7502
Fax
(503) 669-9832
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2008

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 D7358 OR Primary

Addresses

Primary practice location

2039 NE Burnside Rd
Gresham, OR 97030-7998

Mailing address

2039 NE Burnside Rd
Gresham, OR 97030-7998
Phone (503) 669-7502

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
I20151217001065 OR Order and Referring Only - DentistPractitioner - Dentist 3577864412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vicki J Reichlein DMD PC CurrentSince Nov 16, 2021 Accepting new patients

Locations

1388 E Powell Blvd
Gresham, OR 97030
Phone (503) 328-6388

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225843200000",
    "number": "1285795690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2039 NE BURNSIDE RD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307998",
            "telephone_number": "503-669-7502",
            "fax_number": "503-669-9832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2039 NE BURNSIDE RD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307998",
            "telephone_number": "503-669-7502",
            "fax_number": "503-669-9832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICHLEIN",
        "first_name": "VICKI",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2008-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.