Individual provider Active NPI

Jason L Murray, D.D.S.

  • General Practice Dentistry
  • Happy Valley, OR
National Provider Identifier
1821310673
Registry record updated Feb 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D9523 Issued in OR
Practice address
12000 SE 82ND Ave Ste 1145
Happy Valley, OR 97086-7735
Phone
(503) 653-9870
NPI assigned
Feb 22, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60174477 WA
General Practice Dentistry 1223G0001X D12663 MN
General Practice Dentistry 1223G0001X D9523 OR Primary

Addresses

Primary practice location

12000 SE 82ND Ave Ste 1145
Happy Valley, OR 97086-7735

Mailing address

38 Westpointe Dr
Longview, WA 98632-6224
Phone (612) 730-7877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20150713001473 MN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3779896261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE60174477WAMDDentist
D12663MNMDGeneral Practice Dentistry
D9523ORMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1266796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1821310673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 WESTPOINTE DR",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986326224",
            "telephone_number": "612-730-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 SE 82ND AVE STE 1145",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970867735",
            "telephone_number": "503-653-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "JASON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-22",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60174477",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12663",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Happy Valley, OR

Sources for this page

Verify at the official NPI Registry.