Active NPI
Estivali Carrillo
- Dental Hygienist
- Beaverton, OR
National Provider Identifier
1861225401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- H8898
- Practice address
- 2725 SW Cedar Hills Blvd Ste 200
Beaverton, OR 97005-1435 - Phone
- (503) 352-6000
- NPI assigned
- Aug 20, 2024
- 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 | H8898 | OR | Primary |
Addresses
Primary practice location
2725 SW Cedar Hills Blvd Ste 200
Beaverton, OR 97005-1435
Mailing address
25748 SW Canyon Creek Rd Apt A303
Wilsonville, OR 97070-5620
Phone (626) 423-4002
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 |
|---|---|---|---|
| H8898 | OR | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724112000000",
"number": "1861225401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25748 SW CANYON CREEK RD APT A303",
"city": "WILSONVILLE",
"state": "OR",
"postal_code": "970705620",
"telephone_number": "626-423-4002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2725 SW CEDAR HILLS BLVD STE 200",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970051435",
"telephone_number": "503-352-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRILLO",
"first_name": "ESTIVALI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-20",
"last_updated": "2024-08-20",
"certification_date": "2024-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "OR",
"license": "H8898",
"primary": true
}
],
"identifiers": [],
"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 Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.