Jessica Mintie Kloenne, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

D10301 Issued in OR

Practice address

511 SW 10TH Ave
Ste 804
Portland, OR 97205-2732

Phone

(503) 243-2505

NPI assigned

Jul 20, 2015

Sex

Female

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Robert a. Leon, D.M.D., P.C.

  • General Practice Dentistry
  • Portland, OR
  • NPI 1558617720
  NPD (past)

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1891179875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 SW 10TH AVE STE 804",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052709",
            "telephone_number": "503-243-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 SW 10TH AVE",
            "address_2": "STE 804",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052732",
            "telephone_number": "503-243-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOENNE",
        "first_name": "JESSICA",
        "middle_name": "MINTIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-20",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Robert Klinkert, M.S.W.
• Gretchen Geuder Klipp, LCSW
• David M Klipper, DO
• Zachary Klipstein
• Priscilla Klockner, M.A.
• Terra Kloepfer
• Gretchen Kloeppel, LMT
• Elena Tessler Kloer
• Kathryn Olivia Kloos, ND, LMT
• Julie Anne Klopf, RN

• Dentist in Portland, OR
• Providers in Portland, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.