Active NPI
Mandy Leann Hanney
- Dental Assistant
- Beaverton, OR
National Provider Identifier
1851540967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- Practice address
- 4855 SW Western Ave
Beaverton, OR 97005-3460 - Phone
- (503) 626-4148
- NPI assigned
- Sep 12, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | Primary |
Addresses
Primary practice location
4855 SW Western Ave
Beaverton, OR 97005-3460
Mailing address
660 SE Parks Dr
Dundee, OR 97115-9771
Phone (503) 537-4080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 126800000X | Other | OR | DENTAL |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221177600000",
"number": "1851540967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 SE PARKS DR",
"city": "DUNDEE",
"state": "OR",
"postal_code": "971159771",
"telephone_number": "503-537-4080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4855 SW WESTERN AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970053460",
"telephone_number": "503-626-4148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNEY",
"first_name": "MANDY",
"middle_name": "LEANN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-12",
"last_updated": "2008-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL",
"identifier": "126800000X",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.