Active NPI
Corry Berland
- Dental Assistant
- Portland, OR
National Provider Identifier
1902661234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 123694
- Practice address
- Kaiser Permanente Glisan Dental 10102 NE Glisan Street
Portland, OR 97220 - Phone
- (503) 257-5959
- NPI assigned
- Feb 15, 2024
- Last updated
- Feb 15, 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 Assistant | 126800000X | 123694 | OR | Primary |
Addresses
Primary practice location
Kaiser Permanente Glisan Dental 10102 NE Glisan Street
Portland, OR 97220
Mailing address
Kaiser Permanente Glisan Dental 10102 NE Glisan St
Portland, OR 97220
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 |
|---|---|---|---|
| 123694 | OR | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707955200000",
"number": "1902661234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "KAISER PERMANENTE GLISAN DENTAL 10102 NE GLISAN ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "KAISER PERMANENTE GLISAN DENTAL 10102 NE GLISAN STREET",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97220",
"telephone_number": "503-257-5959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERLAND",
"first_name": "CORRY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-15",
"last_updated": "2024-02-15",
"certification_date": "2024-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "OR",
"license": "123694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.