Individual provider Active NPI

Kent S Zerr, D.M.D.

  • General Practice Dentistry
  • Salem, OR
National Provider Identifier
1295727402
Registry record updated Dec 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D5648 Issued in OR
Practice address
2601 25TH St SE
Suite 430
Salem, OR 97302-1279
Phone
(503) 370-8778
Fax
(503) 370-8628
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2009

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 D5648 OR Primary

Addresses

Primary practice location

2601 25TH St SE
Suite 430
Salem, OR 97302-1279

Mailing address

2601 25TH St SE
Suite 430
Salem, OR 97302-1279
Phone (503) 370-8778

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
I20150622000939 OR Order and Referring Only - DentistPractitioner - Dentist 4981692753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D5648ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Dental Center, LLC General Practice Past Accepting new patients

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261353600000",
    "number": "1295727402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 25TH ST SE",
            "address_2": "SUITE 430",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021279",
            "telephone_number": "503-370-8778",
            "fax_number": "503-370-8628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 25TH ST SE",
            "address_2": "SUITE 430",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021279",
            "telephone_number": "503-370-8778",
            "fax_number": "503-370-8628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZERR",
        "first_name": "KENT",
        "middle_name": "S",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2009-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D5648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.