Organization Active NPI

Prodental Hygiene LLC

  • Physical Disabilities Residential Treatment Facility
  • Hillsboro, OR
National Provider Identifier
1508130642
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X
Legal business name
PRODENTAL HYGIENE LLC
Practice address
6279 NE Carillion Dr Unit 103
Hillsboro, OR 97124-8092
Phone
(503) 729-2864
NPI assigned
Mar 7, 2012
Last updated
Mar 7, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Authorized official

Name
Lilia V Hamblin, RDHNPI 1831460872
Title
Dental Hygienist
Phone
(503) 729-2864

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU
Alzheimer Center (Dementia Center) 311500000X NU
Adult Care Home Facility 311ZA0620X NU
Pediatric Skilled Nursing Facility 3140N1450X NU
Physical Disabilities Residential Treatment Facility 320700000X NU Primary

Addresses

Primary practice location

6279 NE Carillion Dr Unit 103
Hillsboro, OR 97124-8092

Mailing address

6279 NE Carillion Dr Unit 103
Hillsboro, OR 97124-8092

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331078400000",
    "number": "1508130642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6279 NE CARILLION DR UNIT 103",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971248092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6279 NE CARILLION DR UNIT 103",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971248092",
            "telephone_number": "503-729-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODENTAL HYGIENE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-07",
        "last_updated": "2012-03-07",
        "status": "A",
        "authorized_official_last_name": "HAMBLIN",
        "authorized_official_first_name": "LILIA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "DENTAL HYGIENIST",
        "authorized_official_telephone_number": "503-729-2864",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; 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.