Clayton LJ Scarzella, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D6515 Issued in OR

Practice address

10102 NE Glisan St
Portland, OR 97220-4456

Phone

(503) 257-5959

Fax

(503) 408-1472

NPI assigned

Aug 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508874975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5105 N CONCORD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972173709",
            "telephone_number": "503-289-0128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10102 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204456",
            "telephone_number": "503-257-5959",
            "fax_number": "503-408-1472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCARZELLA",
        "first_name": "CLAYTON",
        "middle_name": "LJ",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan E Scarboro
• Christiano Peter Scarcella, OTR/L
• Lauranell Scarfo, LCSW
• Marjorie Scarlett, L.M.T.
• Nancy A Scarlett, ND
• Giuliano Amerigo Scasso, QMHA
• Adrienne Mae Scavera, QMHA
• Ellie Sceeles
• Holly Schaaf
• Julie A Schaaff, RN

• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• 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.
• 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.