Individual provider Active NPI

Lisa Joanne Guerrero, D.D.S.

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1447418231
Registry record updated May 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D9066 Issued in OR
Practice address
1314 NE Grand Ave
Portland, OR 97232-1127
Phone
(503) 280-2877
NPI assigned
May 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D9066 OR Primary

Addresses

Primary practice location

1314 NE Grand Ave
Portland, OR 97232-1127

Mailing address

1314 NE Grand Ave
Portland, OR 97232-1127
Phone (503) 280-2877

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110726000264 OR Order and Referring Only - DentistPractitioner - Dentist 3678741212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D9066ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Permanente Past Accepting new patients

Organizations & group practices 1

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": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211932800000",
    "number": "1447418231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 NE GRAND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321127",
            "telephone_number": "503-280-2877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 NE GRAND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321127",
            "telephone_number": "503-280-2877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "LISA",
        "middle_name": "JOANNE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2008-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.