Individual provider Active NPI

Nahmjee Lee Skarada, D.M.D.

  • General Practice Dentistry
  • Salem, OR
National Provider Identifier
1629224365
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D8837 Issued in OR
Practice address
340 Vista Ave SE Ste 100
Salem, OR 97302-4546
Phone
(503) 584-1174
Fax
(503) 584-1330
NPI assigned
Aug 13, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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 D8837 OR Primary

Addresses

Primary practice location

340 Vista Ave SE Ste 100
Salem, OR 97302-4546

Mailing address

340 Vista Ave SE Ste 100
Salem, OR 97302-4546
Phone (503) 584-1174

Other names 1

  • Dr. Nahmjee Lee Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D8837ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Nose Clinic LLC CurrentSince Jul 24, 2022 Accepting new patients
Modern Nose Clinic LLC PastSince Jul 24, 2022 Accepting new patients

Locations

340 Vista Ave SE
Ste 100
Salem, OR 97302
Phone (503) 584-1174

19150 SW 90th Ave
Tualatin, OR 97062

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1629224365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 VISTA AVE SE STE 100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024546",
            "telephone_number": "503-584-1174",
            "fax_number": "503-584-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 VISTA AVE SE STE 100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024546",
            "telephone_number": "503-584-1174",
            "fax_number": "503-584-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE SKARADA",
        "first_name": "NAHMJEE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NAHMJEE",
            "last_name": "LEE",
            "prefix": "DR.",
            "credential": "D.M.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.