Individual provider Active NPI

Pamela S. Martin, RDH WITH LAP

  • Dental Hygienist
  • Eagle Point, OR
National Provider Identifier
1770801094
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
H4261 Issued in OR
Practice address
16300 Highway 62
Eagle Point, OR 97524-7858
Phone
(541) 621-6094
NPI assigned
May 11, 2010
Last updated
Jan 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X H4261 OR Primary

Addresses

Primary practice location

16300 Highway 62
Eagle Point, OR 97524-7858

Mailing address

16300 Highway 62
Eagle Point, OR 97524-7858
Phone (541) 621-6094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
H4261ORMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Smiles Happy Hearts, LLC Dental Hygienist 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1770801094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16300 HIGHWAY 62",
            "city": "EAGLE POINT",
            "state": "OR",
            "postal_code": "975247858",
            "telephone_number": "541-621-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16300 HIGHWAY 62",
            "city": "EAGLE POINT",
            "state": "OR",
            "postal_code": "975247858",
            "telephone_number": "541-621-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "PAMELA",
        "middle_name": "S.",
        "credential": "RDH WITH LAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-11",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OR",
            "license": "H4261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Point, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.