Sylvia G Jimenez, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9979 Issued in OR

Practice address

11398 SE 82ND Ave
Ste 802
Clackamas, OR 97086-7637

Phone

(503) 513-6000

NPI assigned

Apr 4, 2007

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

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Clackamas Square Dental Group, PC

  • General Practice Dentistry
  • Happy Valley, OR
  • NPI 1336578418
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388102400000",
    "number": "1366564825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11398 SE 82ND AVE",
            "address_2": "STE 802",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970867637",
            "telephone_number": "503-513-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11398 SE 82ND AVE",
            "address_2": "STE 802",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970867637",
            "telephone_number": "503-513-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "SYLVIA",
        "middle_name": "G",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2013-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DDS LICENSE #",
            "identifier": "6393",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Jensen, PMHNP
• Charles Jerabek
• Jerry Keith Counseling LLC
• Patricia L Jilot, PTA
• Alicia Brianna Jimenez, CADC-R
• JMB Dental PC
• Catherine John, MD
• Ryan David Johnsen, MD
• Angela Nicole Johnson, PT
• Ashley Johnson, SLP

• General Practice Dentistry in Clackamas, OR
• Providers in Clackamas, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.