Individual provider Active NPI

Aaron Nickolas Boren, D.M.D.

  • Dentist
  • Milwaukie, OR
National Provider Identifier
1558526038
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D9149 Issued in OR
Practice address
6902 SE Lake Rd
Suite 200
Milwaukie, OR 97267-2148
Phone
(503) 659-0930
Fax
(503) 654-3846
NPI assigned
Jul 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D9149 OR Primary

Addresses

Primary practice location

6902 SE Lake Rd
Suite 200
Milwaukie, OR 97267-2148

Mailing address

6950 NE Campus Way
Hillsboro, OR 97124-5611
Phone (503) 952-2167

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150521000743 OR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9739409376

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1558526038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 NE CAMPUS WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245611",
            "telephone_number": "503-952-2167",
            "fax_number": "503-952-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6902 SE LAKE RD",
            "address_2": "SUITE 200",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972672148",
            "telephone_number": "503-659-0930",
            "fax_number": "503-654-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOREN",
        "first_name": "AARON",
        "middle_name": "NICKOLAS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-23",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

Verify at the official NPI Registry.