Individual provider Active NPI

Lyubov V. Chain

  • Dental Assistant
  • Vancouver, WA
National Provider Identifier
1457654022
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
60075399 Issued in WA
Practice address
12711 SE Mill Plain Blvd
Vancouver, WA 98684-5089
Phone
(360) 896-4484
NPI assigned
Dec 21, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X 60075399 WA Primary

Addresses

Primary practice location

12711 SE Mill Plain Blvd
Vancouver, WA 98684-5089

Mailing address

275 SW Riverview Ave
Gresham, OR 97080-6772

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
60075399WAMDDental Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Permanente Dental Care Program 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": "1292889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1457654022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 SW RIVERVIEW AVE",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970806772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12711 SE MILL PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845089",
            "telephone_number": "360-896-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAIN",
        "first_name": "LYUBOV",
        "middle_name": "V.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-21",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "WA",
            "license": "60075399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.