Individual provider Active NPI

Margaret Elaine Anderson Brunner, DDS

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1548338809
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7892 Issued in OR
Practice address
12750 SE Stark St BLDG E
Portland, OR 97233-1539
Phone
(971) 347-3009
Fax
(971) 257-3277
NPI assigned
Dec 2, 2006
Last updated
Apr 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D7892 OR Primary

Addresses

Primary practice location

12750 SE Stark St BLDG E
Portland, OR 97233-1539

Mailing address

211 SE Caruthers St
Portland, OR 97214-4502
Phone (971) 217-9008

Other identifiers 1

IdentifierTypeStateIssuer
230637MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240315001108 TX Practitioner - Dentist 9638485626
I20250423002311 OR Practitioner - Dentist 9638485626 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Native American Rehabilitation Assoc Inc CurrentSince Mar 3, 2025 Accepting new patients
Native American Rehabilitation Assoc Inc Current Accepting new patients
Native American Rehabilitation Assoc Inc CurrentSince Mar 3, 2025 Accepting new patients
Christopher D Kooning, DMD PC Past Accepting new patients

Locations

12360 E Burnside St
Portland, OR 97233
Phone (971) 279-4800

12750 SE Stark St
Bldg E
Portland, OR 97233
Phone (971) 347-3009

211 SE Caruthers St
Portland, OR 97214
Phone (503) 224-1044

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1548338809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SE CARUTHERS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144502",
            "telephone_number": "971-217-9008",
            "fax_number": "971-260-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12750 SE STARK ST BLDG E",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331539",
            "telephone_number": "971-347-3009",
            "fax_number": "971-257-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON BRUNNER",
        "first_name": "MARGARET",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-02",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230637",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.