Active NPI
Igor Alekseyevich Sotnikov, RDH EPP
- Dental Hygienist
- Portland, OR
National Provider Identifier
1689253817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- H7943
- Practice address
- 2520 SE 145TH Ave
Portland, OR 97236-2671 - Phone
- (971) 242-4396
- NPI assigned
- Apr 5, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | H7943 | OR | Primary |
Addresses
Primary practice location
2520 SE 145TH Ave
Portland, OR 97236-2671
Mailing address
14352 SE Lee Ave
Milwaukie, OR 97267-1132
Phone (503) 752-4636
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H7943 | OR | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619395200000",
"number": "1689253817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14352 SE LEE AVE",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "972671132",
"telephone_number": "503-752-4636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2520 SE 145TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972362671",
"telephone_number": "971-242-4396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOTNIKOV",
"first_name": "IGOR",
"middle_name": "ALEKSEYEVICH",
"credential": "RDH EPP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-05",
"last_updated": "2021-04-26",
"certification_date": "2021-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "OR",
"license": "H7943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.