Individual provider Active NPI

Sara Birrer, DMD

  • Dentist
  • Portland, OR
National Provider Identifier
1699453860
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D11830 Issued in OR
Practice address
3530 SE 88TH Ave
Portland, OR 97266-2396
Phone
(503) 576-8350
Fax
(503) 371-5338
NPI assigned
Jul 7, 2023
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D11830 OR Primary
General Practice Dentistry 1223G0001X D11830 OR

Addresses

Primary practice location

3530 SE 88TH Ave
Portland, OR 97266-2396

Mailing address

3530 SE 88TH Ave
Portland, OR 97266-2396
Phone (503) 576-8350

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
I20230913004339 OR Order and Referring Only - DentistPractitioner - Dentist 3678937372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D11830ORMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1699453860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 SE 88TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662396",
            "telephone_number": "503-576-8350",
            "fax_number": "503-371-5338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 SE 88TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662396",
            "telephone_number": "503-576-8350",
            "fax_number": "503-371-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRRER",
        "first_name": "SARA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11830",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D11830",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.