Robert Highley Everett

Primary specialty

DentistTaxonomy code 122300000X

License

D5777 Issued in OR

Practice address

325 Portland Ave
Gladstone, OR 97027-2450

Phone

(503) 656-8426

NPI assigned

Aug 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Robert Everett Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Happy Rock Dental

  • Dental Clinic/Center
  • Gladstone, OR
  • NPI 1740044726
  NPD Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669583472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 PORTLAND AVE",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970272450",
            "telephone_number": "503-656-8426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 PORTLAND AVE",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970272450",
            "telephone_number": "503-656-8426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERETT",
        "first_name": "ROBERT",
        "middle_name": "HIGHLEY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D5777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "D5777",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "EVERETT",
            "credential": "DMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Dentist in Gladstone, OR
• Providers in Gladstone, OR by specialty
• Dentist in Oregon

• 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.