NPIMap

Individual provider Active NPI

Rares N Deca, D.M.D.

  • Endodontics
  • Aloha, OR
National Provider Identifier
1326277708
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D10376 Issued in OR
Practice address
18395 SW Alexander St
Aloha, OR 97003-3961
Phone
(503) 642-4552
NPI assigned
Jul 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DE60705325 WA
Endodontics 1223E0200X 055991 NY
Endodontics 1223E0200X D10376 OR Primary
General Practice Dentistry 1223G0001X DL10639 MA

Addresses

Primary practice location

18395 SW Alexander St
Aloha, OR 97003-3961

Mailing address

18395 SW Alexander St
Aloha, OR 97003-3961
Phone (503) 642-4552

Other practice location 1

501 NE Hood Ave Ste 235
Gresham, OR 97030-7346
Phone (503) 661-4900

Other practice location 2

601 SE 117th Ave
#110
Vancouver, WA 98683-5297
Phone (360) 334-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective May 18, 2016 through May 18, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE60705325WAMDEndodontist
DL10639MAMDGeneral Practice Dentistry
055991NYMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pearl Endodontics, PC Endodontics CurrentSince May 24, 2020 Accepting new patients
Chao Shen DMD PLLC Endodontics PastSince Jul 3, 2022 Accepting new patients
Vancouver Endodontic Specialists PC Inc. Endodontics Past Accepting new patients
Deca Dentistry Endodontics Past Accepting new patients
Northwest Endodontics, PC Endodontics PastSince May 24, 2020 Accepting new patients

Locations

18395 SW Alexander St
Aloha, OR 97003
Phone (503) 642-4552

Organizations & group practices 5

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": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1326277708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18395 SW ALEXANDER ST",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970033961",
            "telephone_number": "503-642-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18395 SW ALEXANDER ST",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970033961",
            "telephone_number": "503-642-4552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 NE Hood Ave Ste 235",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970307346",
            "country_code": "US",
            "telephone_number": "503-661-4900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 SE 117th Ave",
            "address_2": "#110",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986835297",
            "country_code": "US",
            "telephone_number": "360-334-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECA",
        "first_name": "RARES",
        "middle_name": "N",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-07",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE60705325",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "055991",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OR",
            "license": "D10376",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DL10639",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aloha, OR

Sources for this page

Verify at the official NPI Registry.