Individual provider Active NPI

Kelly Smith, RDH

  • Dental Hygienist
  • Portland, OR
National Provider Identifier
1447877899
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
H5548 Issued in OR
Practice address
7700 SW Garden Home Rd Apt 24
Portland, OR 97223-7496
Phone
(503) 954-5321
NPI assigned
Jul 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X H5548 OR Primary

Addresses

Primary practice location

7700 SW Garden Home Rd Apt 24
Portland, OR 97223-7496

Mailing address

2020 SE 182ND Ave
Portland, OR 97233-5692
Phone (503) 954-5321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
H5548ORMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1447877899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 SE 182ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972335692",
            "telephone_number": "503-954-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 SW GARDEN HOME RD APT 24",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972237496",
            "telephone_number": "503-954-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLY",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OR",
            "license": "H5548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.