Individual provider Active NPI

Nhu Thi Khanh Ho, DMD

  • Dentist
  • Portland, OR
National Provider Identifier
1760157929
Registry record updated Apr 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D11489 Issued in OR
Practice address
4506 SE 105TH Ave
Portland, OR 97266-3528
Phone
(503) 250-2550
NPI assigned
Aug 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE61195226 WA
Dentist 122300000X D11489 OR Primary

Addresses

Primary practice location

4506 SE 105TH Ave
Portland, OR 97266-3528

Mailing address

10253 SE Nicole Loop
Happy Valley, OR 97086-6879
Phone (971) 717-1302

Other names 1

  • Hibery Ho Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20211111001536 CA Order and Referring Only - DentistPractitioner - Dentist 4880083922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D11489ORMDDentist
DE61195226WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
King & Crown LLC Dentist CurrentSince Apr 27, 2025 Accepting new patients
Washington Dental Corporation PC PastSince Aug 1, 2021 Accepting new patients

Locations

4506 SE 105th Ave
Portland, OR 97266
Phone (503) 250-2550

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745625600000",
    "number": "1760157929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10253 SE NICOLE LOOP",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970866879",
            "telephone_number": "971-717-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4506 SE 105TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972663528",
            "telephone_number": "503-250-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HO",
        "first_name": "NHU",
        "middle_name": "THI KHANH",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-10",
        "last_updated": "2025-04-26",
        "certification_date": "2025-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61195226",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HIBERY",
            "last_name": "HO",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.