Active NPI
Jessica Buenjemia, DDS
- General Practice Dentistry
- North Bend, OR
National Provider Identifier
1710967336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D8493
- Practice address
- 2157 Broadway St
North Bend, OR 97459-2329 - Phone
- (541) 751-1915
- NPI assigned
- Jan 19, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D8493 | OR | Primary |
Addresses
Primary practice location
2157 Broadway St
North Bend, OR 97459-2329
Mailing address
1001 SE Tualatin Valley Hwy
Ste A16
Hillsboro, OR 97123-4977
Phone (503) 693-1217
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 023013 | Medicaid | OR |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170116000467 | OR | Order and Referring Only - Other (Physician) | 0244512861 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hayden Family Dentistry Group | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- North Bend, OR
- NPI 1346464328
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1710967336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 SE TUALATIN VALLEY HWY",
"address_2": "STE A16",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971234977",
"telephone_number": "503-693-1217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2157 BROADWAY ST",
"city": "NORTH BEND",
"state": "OR",
"postal_code": "974592329",
"telephone_number": "541-751-1915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUENJEMIA",
"first_name": "JESSICA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-19",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D8493",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "023013",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in North Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.