Sara Ann Edmondson, DMD MDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D11233 Issued in OR

Practice address

3943 Douglas Way
Lake Oswego, OR 97035-3453

Phone

(503) 389-0976

NPI assigned

Jun 18, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Dischinger and Ensley Orthodontic Group Two LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lake Oswego, OR
  • NPI 1770382814
  NPD

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1356910947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5248 DENTON DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970355736",
            "telephone_number": "503-329-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3943 DOUGLAS WAY",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353453",
            "telephone_number": "503-389-0976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10850 NE Halsey St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972203047",
            "country_code": "US",
            "telephone_number": "503-255-1694",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4095 SW 144th Ave",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970052368",
            "country_code": "US",
            "telephone_number": "503-644-7009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "SARA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DMD MDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-18",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OR",
            "license": "D11233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Gerard Duyck, PTA
• Alyson Anne Dziedzic, MSW
• Darrel Worthley Eacret, PHD
• Jillian Eberhard
• Adrian Bernard Echols, QMHA
• Timothy John Edvalson, D.M.D.
• Emma Edwards
• Lauren Edwards, LCSW
• Stephen Eguia
• Karrie Marie J Ehlers, PSYD

• Orthodontics and Dentofacial Orthopedics Dentistry in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.