Active NPI
Laurie Lee Kelly, RDH
- Dental Hygienist
- Lake Oswego, OR
National Provider Identifier
1467517664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- H2626
- Practice address
- 4550 Dogwood Dr
Lake Oswego, OR 97035-8410 - Phone
- (503) 310-9485
- Fax
- (503) 620-1635
- NPI assigned
- Dec 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | H2626 | OR | Primary |
Addresses
Primary practice location
4550 Dogwood Dr
Lake Oswego, OR 97035-8410
Mailing address
4550 Dogwood Dr
Lake Oswego, OR 97035-8410
Phone (503) 310-9485
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
| License | State | Type | Specialty |
|---|---|---|---|
| H2626 | OR | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467517664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4550 DOGWOOD DR",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970358410",
"telephone_number": "503-310-9485",
"fax_number": "503-620-1635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4550 DOGWOOD DR",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970358410",
"telephone_number": "503-310-9485",
"fax_number": "503-620-1635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "LAURIE",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "OR",
"license": "H2626",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Oswego, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.