Active NPI
Kaylynn Walls, RDH
- Dental Hygienist
- Tillamook, OR
National Provider Identifier
1851938989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- H7953
- Practice address
- 1103 3Rd St
Tillamook, OR 97141-3402 - Phone
- (503) 842-6666
- NPI assigned
- Dec 9, 2019
- Last updated
- Dec 9, 2019
- 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 Hygienist | 124Q00000X | H7953 | OR | Primary |
Addresses
Primary practice location
1103 3Rd St
Tillamook, OR 97141-3402
Mailing address
516 Main Ave # a
Tillamook, OR 97141-3543
Phone (503) 964-2732
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | OpenDental |
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
| License | State | Type | Specialty |
|---|---|---|---|
| H7953 | OR | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thompson Mainstay LLC | Current | Accepting new patients | |
| Benjamin Zike DDS | Past | Accepting new patients |
Locations
1103 3rd St
Tillamook, OR 97141
Phone (503) 842-6268
Organizations & group practices 2
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": "1575849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575849600000",
"number": "1851938989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "516 MAIN AVE # A",
"city": "TILLAMOOK",
"state": "OR",
"postal_code": "971413543",
"telephone_number": "503-964-2732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1103 3RD ST",
"city": "TILLAMOOK",
"state": "OR",
"postal_code": "971413402",
"telephone_number": "503-842-6666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLS",
"first_name": "KAYLYNN",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-09",
"last_updated": "2019-12-09",
"certification_date": "2019-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "OR",
"license": "H7953",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "OpenDental",
"affiliation": "N",
"address_1": "1103 3rd St",
"city": "Tillamook",
"state": "OR",
"country_code": "US",
"postal_code": "971413402",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Tillamook, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.