Individual provider Active NPI

Kara L Opheim, DDS

  • Dentist
  • Salem, OR
National Provider Identifier
1306257134
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.030570 Issued in IL
Practice address
1355 Edgewater St NW
Salem, OR 97304-4077
Phone
(503) 588-6960
NPI assigned
May 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.030570 IL Primary

Addresses

Primary practice location

1355 Edgewater St NW
Salem, OR 97304-4077

Mailing address

1835 Broadway St
Melrose Park, IL 60160-2040
Phone (708) 548-3727

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.030570ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Crisdental Salem L.L.C. General Practice Past Accepting new patients
William J. Blaumer Dentist Past Accepting new patients

Organizations & group practices 2

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": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1306257134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 BROADWAY ST",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601602040",
            "telephone_number": "708-548-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 EDGEWATER ST NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044077",
            "telephone_number": "503-588-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPHEIM",
        "first_name": "KARA",
        "middle_name": "L",
        "name_prefix": "Miss",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-14",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.030570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.