Michael Koenen Setter, D.D.S.,M.S.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

D9674 Issued in OR

Practice address

2075 SW 1St Ave
#2L
Portland, OR 97201-5314

Phone

(503) 505-4341

NPI assigned

Oct 17, 2011

Sex

Male

Sole proprietor

Yes

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": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1427333822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 SW 1ST AVE",
            "address_2": "#2L",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 SW 1ST AVE",
            "address_2": "#2L",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015314",
            "telephone_number": "503-505-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SETTER",
        "first_name": "MICHAEL",
        "middle_name": "KOENEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.,M.S.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-17",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60022749",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019827",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OR",
            "license": "D9674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth V. Senestraro DDS, PC
• Stephen D Sethi, MD
• Kimberly Marie Seto, L.M.T.
• Helle Setsaa Rivas
• Jodi Kay Settelmeyer, PT
• Christopher Scott Seuferling, DPM
• Amy Elizabeth Seufert
• Christie L Seumalo, M.S.
• Christina Jinsook Seung
• Lisa Ann Seung, PA-C

• Periodontics in Portland, OR
• Providers in Portland, OR by specialty
• Periodontics in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.