Lilia Herrera, D.D.S.
Individual provider Active NPI General Practice Dentistry · Portland, OR
NPI 1740309558 · NPPES record last updated Oct 10, 2019
Key facts
- NPI
- 1740309558
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D8512 (OR)
- Practice address
- 2150 NE 82ND Ave
Portland, OR 97220-5607 - Phone
- (503) 254-0896
- Fax
- (541) 516-4055
- NPI assigned
- Mar 29, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200109002299 | OR | Order and Referring Only - Dentist |
1254766744 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advantage Dental Group, PC | General Practice | Past |
Accepting new patients |
| Advantage Dental Group, PC | General Practice | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D8512 | OR | Yes |
Addresses
Primary practice location
2150 NE 82ND Ave
Portland, OR 97220-5607
Mailing address
PO Box 11470
Eugene, OR 97440-3670
Phone (503) 254-0896
Other practice location 1
4392 Liberty Rd S
Salem, OR 97302-6171
Phone (503) 585-7447
Other providers in Portland, OR
- Donita Marie Herrera
- Gabrielle Herrera
- Holly Natasha Herrera
- Jasmine Herrera
- Laura Elizabeth Herrera
- Timothy Leland Herrick
- Violet Ann Herrick
- Wendy Kay Herrick
- Brock D Herriges
- Bridget Marie Herrin
All providers in Portland, OR · General Practice Dentistry in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.