Sita Lisa Ping, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D10729 Issued in OR

Practice address

2381 NE Conners Ave
Bend, OR 97701-6068

Phone

(541) 678-6262

NPI assigned

Aug 30, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1396263398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10505 SE 17TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972227475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2381 NE CONNERS AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016068",
            "telephone_number": "541-678-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PING",
        "first_name": "SITA",
        "middle_name": "LISA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "NA",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10729",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D10729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paisley Pijuan, LCSW
• Megan Elisa Pike, QMHA-1
• Tamara Pike
• Edmund Pennington Pillsbury III, MD
• Pine Springs Health LLC
• Breezy Pinkerton, CRM
• Faith Tavares Pinkerton, L.D.
• Rachel Rae Pinkston, QMHA
• Robert V Pinnick, MD
• Christie Pirkle, PT, DPT

• Pediatric Dentistry in Bend, OR
• Providers in Bend, OR by specialty
• Pediatric Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.