Jacqueline Bellez, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11616 Issued in OR

Practice address

926 NW 13TH Ave Ste 150
Portland, OR 97209-3090

Phone

(503) 227-2444

NPI assigned

May 14, 2021

Last updated

May 8, 2023By the provider in NPPES

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)

Enrolled

State licenses

Practice roles

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.

• Kathryn J Ball DMD PC

  • General Practice Dentistry
  • Portland, OR
  • NPI 1992147458
  NPD (past)
• Portland Modern Dentistry, PC

  dba Portland Modern Dentistry

  • Dentist
  • Portland, OR
  • NPI 1598223919
  NPD (past)
• Salt Lake Modern Dentistry, LLP

  • General Practice Dentistry
  • Salt Lake City, UT
  • NPI 1730647330
  NPD (past)

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1902470966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 NW 13TH AVE STE 150",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093090",
            "telephone_number": "503-227-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 NW 13TH AVE STE 150",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093090",
            "telephone_number": "503-227-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLEZ",
        "first_name": "JACQUELINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-14",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D11616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Bellavara
• Maia Antoinette Bellavia
• Elise Marie Bellcoff, AGACNP-BC
• Corey Belle-Isle
• Heather Beller, M.A.
• Britt Wilde Belling, CRNA
• Cheri Lynn Belling, FNP
• Paul D Bellis, LAC
• Brigid Bello, MSW
• Janelle Eileen Bello

• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.