Individual provider Active NPI

Kariana Peters, DMD

  • Dentist
  • Portland, OR
National Provider Identifier
1821254350
Registry record updated May 7, 2015
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D9159 Issued in OR
Practice address
1933 SW Jefferson St
Portland, OR 97201-2405
Phone
(503) 273-8240
Fax
(503) 228-4344
NPI assigned
Aug 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D9159 OR Primary

Addresses

Primary practice location

1933 SW Jefferson St
Portland, OR 97201-2405

Mailing address

6950 NE Campus Way
Hillsboro, OR 97124-5611
Phone (503) 952-2164

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
I20150520002687 OR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9436479151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430956800000",
    "number": "1821254350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 NE CAMPUS WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245611",
            "telephone_number": "503-952-2164",
            "fax_number": "503-526-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 SW JEFFERSON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972012405",
            "telephone_number": "503-273-8240",
            "fax_number": "503-228-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "KARIANA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2015-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.