Manerva Jeanette Hart, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D11725 Issued in OR

Practice address

1710 NE 122ND Ave
Portland, OR 97230-1939

Phone

(503) 295-2120

NPI assigned

Jun 24, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Practice roles

Locations

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.

• Hart and Lee Dental Corporation

  • Dentist
  • Hemet, CA
  • NPI 1699264473
  NPD (past) Authorized official
• Russell Modern Dentistry, PC

  • General Practice Dentistry
  • Portland, OR
  • NPI 1063173466
  NPD
• Lee Watanabe and Nosti Dental Corporation

  • General Practice Dentistry
  • Hemet, CA
  • NPI 1740389162
  NPD (past)

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1457733529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 NE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972301939",
            "telephone_number": "503-740-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 NE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972301939",
            "telephone_number": "503-295-2120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1115 S Sanderson Ave",
            "address_purpose": "LOCATION",
            "city": "Hemet",
            "state": "CA",
            "postal_code": "925459047",
            "country_code": "US",
            "telephone_number": "951-404-5307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HART",
        "first_name": "MANERVA",
        "middle_name": "JEANETTE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100438",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Rose Hart
• Kaylee M Hart
• Kristen E Hart, L.AC
• Larry S Hart, PH.D.
• Lea Hart
• Mark V Hart, M.D.
• Molly Hart
• Natalie Hart, RN
• Natalie Hart, PHARMD
• Rachael May Hart, PA-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.