Individual provider Active NPI

Alexis Lee Kleinman, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Albany, NY
National Provider Identifier
1316217540
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
D10023 Issued in OR
Practice address
2 Executive Park Dr
Albany Oms Group
Albany, NY 12203-3700
Phone
(518) 446-1001
NPI assigned
Jan 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X D10023 OR Primary

Addresses

Primary practice location

2 Executive Park Dr
Albany Oms Group
Albany, NY 12203-3700

Mailing address

19075 NW Tanasbourne Drive #300
Sunset Dental Office
Hillsboro, OR 97124-3700
Phone (503) 531-1700

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
I20141001000844 OR Practitioner - Oral Surgery 2062632771 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D10023ORMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Apr 7, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Apr 7, 2021 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

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": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1316217540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19075 NW TANASBOURNE DRIVE #300",
            "address_2": "SUNSET DENTAL OFFICE",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971243700",
            "telephone_number": "503-531-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EXECUTIVE PARK DR",
            "address_2": "ALBANY OMS GROUP",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033700",
            "telephone_number": "518-446-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEINMAN",
        "first_name": "ALEXIS",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-04",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D10023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.