Individual provider Active NPI

Anne Purcell, DMD

  • Pediatric Dentistry
  • Hillsboro, OR
National Provider Identifier
1851824460
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D10929 Issued in OR
Practice address
150 SE 3Rd Ave
Hillsboro, OR 97123-4019
Phone
(503) 213-2157
NPI assigned
Apr 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D10929 OR
Pediatric Dentistry 1223P0221X DS043105 PA
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Dentistry 1223P0221X D10929 OR Primary

Addresses

Primary practice location

150 SE 3Rd Ave
Hillsboro, OR 97123-4019

Mailing address

300 Willowbrook LN Ste 300
West Chester, PA 19382-5594

Other identifiers 1

IdentifierTypeStateIssuer
500767313MedicaidOR

Other names 1

  • Anne Purcell Farham Other name

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
I20220927001683 OR Order and Referring Only - DentistPractitioner - Dentist 9739565821

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS043105PAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Dental Group, PC General Practice PastSince Sep 20, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1851824460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WILLOWBROOK LN STE 300",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193825594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SE 3RD AVE",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971234019",
            "telephone_number": "503-213-2157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURCELL",
        "first_name": "ANNE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10929",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS043105",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D10929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500767313",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE",
            "last_name": "FARHAM",
            "middle_name": "PURCELL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.