Individual provider Active NPI

Mary Ann Wren, B.S., RDH, LAP

  • Dental Hygienist
  • Bend, OR
National Provider Identifier
1659660108
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
H5219 Issued in OR
Practice address
2381 NE Conners Ave
Bend, OR 97701-6068
Phone
(541) 389-1704
Fax
(541) 389-1705
NPI assigned
Apr 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X H5219 OR Primary

Addresses

Primary practice location

2381 NE Conners Ave
Bend, OR 97701-6068

Mailing address

2675 SW 49TH St
Redmond, OR 97756-1160
Phone (541) 975-3972

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
H5219ORMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1659660108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 SW 49TH ST",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561160",
            "telephone_number": "541-975-3972",
            "fax_number": "541-389-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2381 NE CONNERS AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016068",
            "telephone_number": "541-389-1704",
            "fax_number": "541-389-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WREN",
        "first_name": "MARY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "B.S., RDH, LAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2011-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OR",
            "license": "H5219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; 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.