Individual provider Active NPI

Jennifer Emily Navis, D.D.S.

  • Dentist
  • Portland, OR
National Provider Identifier
1619317971
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10035 Issued in OR
Practice address
6319 SE Powell Blvd
Portland, OR 97206-2751
Phone
(503) 772-3677
NPI assigned
Jul 1, 2013
Last updated
Jun 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10035 OR Primary

Addresses

Primary practice location

6319 SE Powell Blvd
Portland, OR 97206-2751

Mailing address

6319 SE Powell Blvd
Portland, OR 97206-2751
Phone (503) 772-3677

Other practice location 1

16500 SE 15th St Ste 150
Vancouver, WA 98683-9667
Phone (360) 326-3829

Other names 1

  • Dr. Jennifer Emily Pohl Former name

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
I20160204001335 OR Order and Referring Only - DentistPractitioner - Dentist 9638473010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10035ORMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Special Delivery Dental Care Inc Dentist Past Accepting new patients
Special Delivery Dental Care, PLLC Past Accepting new patients
Geriatric Dental Group Dentist Past Accepting new patients

Organizations & group practices 3

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": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1619317971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6319 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972062751",
            "telephone_number": "503-772-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6319 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972062751",
            "telephone_number": "503-772-3677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16500 SE 15th St Ste 150",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986839667",
            "country_code": "US",
            "telephone_number": "360-326-3829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAVIS",
        "first_name": "JENNIFER",
        "middle_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-01",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "10035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "POHL",
            "middle_name": "EMILY",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.