Lindsey Gaulke Popov, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D9317 Issued in OR

Practice address

17675 SW Tualatin Valley Hwy
Beaverton, OR 97006-4443

Phone

(503) 412-8842

NPI assigned

Aug 13, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lindsey Jean Gaulke Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Dentistry
  • Portland, OR
  • NPI 1689980740
  NPD (past)

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

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330041600000",
    "number": "1689806382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17675 SW TUALATIN VALLEY HWY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064443",
            "telephone_number": "503-412-8842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17675 SW TUALATIN VALLEY HWY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064443",
            "telephone_number": "503-412-8842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPOV",
        "first_name": "LINDSEY",
        "middle_name": "GAULKE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-13",
        "last_updated": "2012-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSEY",
            "last_name": "GAULKE",
            "middle_name": "JEAN",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laurie Polneau, RN
• Makaeyla Pool
• Hataya Kristy Poonyagariyagorn, M.D.
• Khatera Haya Popalzai
• Kathleen Rose Pope
• Karina Porter
• Marissa Madison Porter
• Abigail Portillo
• Portland Dental Works, LLC
• Rebekah Rosemary Posadas, MACP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.