Sheila Suzanne Blacketer, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

H3855 Issued in OR

Practice address

700 53Rd Ave NW
Salem, OR 97304-3248

Phone

(503) 871-5214

NPI assigned

Jan 29, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: sheila.blacketer.p1@direct.grandronde.nextgenshare.com

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1861630808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 53RD AVE NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973043248",
            "telephone_number": "503-871-5214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 53RD AVE NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973043248",
            "telephone_number": "503-871-5214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKETER",
        "first_name": "SHEILA",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OR",
            "license": "H3855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Mary Bjorkquist, PH.D.
• Elizabeth Katherine Bjornskov, M.D.
• Ashlie Lynn Black, MS
• Sharla Black, BS, LMT
• Molly Margaret Blackburn, RDH
• Chelsea Blackett, MD
• Sadie J Blackhall, PA-C
• Christian Blackmore
• Megan Blacksmith, CRC
• Rachel Lyn Blackwood-Perez

• Dental Hygienist in Salem, OR
• Providers in Salem, OR by specialty
• Dental Hygienist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.