Individual provider Active NPI

Coleman Bright, DMD

  • Dentist
  • Milwaukie, OR
National Provider Identifier
1639691652
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D10692 Issued in OR
Practice address
3300 SE Dwyer Dr Ste 302
Milwaukie, OR 97222-6548
Phone
(503) 850-4479
NPI assigned
Jul 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 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 D10692 OR Primary

Addresses

Primary practice location

3300 SE Dwyer Dr Ste 302
Milwaukie, OR 97222-6548

Mailing address

7320 SW Hunziker Rd Ste 300
Portland, OR 97223-2302
Phone (503) 941-3033

Other identifiers 1

IdentifierTypeStateIssuer
500728313MedicaidOR

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
I20190507002718 OR Order and Referring Only - DentistPractitioner - Dentist 0941571434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D10692ORMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health Center Past Accepting new patients
Neighborhood Health Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cbright271139@direct.ochin.org

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": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1639691652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 SW HUNZIKER RD STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972232302",
            "telephone_number": "503-941-3033",
            "fax_number": "503-747-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 SE DWYER DR STE 302",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226548",
            "telephone_number": "503-850-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIGHT",
        "first_name": "COLEMAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-11",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500728313",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

Verify at the official NPI Registry.