Individual provider Active NPI

Sandra Menashe, DMD

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1619011814
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5409 Issued in OR
Practice address
511 SW 10TH Ave
#1107
Portland, OR 97205-2732
Phone
(503) 227-5654
Fax
(503) 227-2314
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5409 OR Primary

Addresses

Primary practice location

511 SW 10TH Ave
#1107
Portland, OR 97205-2732

Mailing address

511 SW 10TH Ave
#1107
Portland, OR 97205-2732
Phone (503) 227-5654

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

LicenseStateTypeSpecialty
5409ORMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619011814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 SW 10TH AVE",
            "address_2": "#1107",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052732",
            "telephone_number": "503-227-5654",
            "fax_number": "503-227-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 SW 10TH AVE",
            "address_2": "#1107",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052732",
            "telephone_number": "503-227-5654",
            "fax_number": "503-227-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENASHE",
        "first_name": "SANDRA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "5409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, 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.

Verify at the official NPI Registry.