Individual provider Active NPI

Kerry Csiga, D.M.D

  • Dentist
  • Gresham, OR
National Provider Identifier
1922483346
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D10323 Issued in OR
Practice address
387 NE 223Rd Ave
Gresham, OR 97030-8554
Phone
(503) 491-5450
NPI assigned
Jul 27, 2015
Last updated
Feb 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D10323 OR Primary

Addresses

Primary practice location

387 NE 223Rd Ave
Gresham, OR 97030-8554

Mailing address

1880 Lancaster Dr NE
Ste 121
Salem, OR 97305-1069
Phone (971) 600-3498

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151020001647 OR Order and Referring Only - DentistPractitioner - Dentist 4486963162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Arrow Dental LLC Past Accepting new patients
Gresham Modern Dentistry, PC Dentist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1922483346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 LANCASTER DR NE",
            "address_2": "STE 121",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051069",
            "telephone_number": "971-600-3498",
            "fax_number": "971-600-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 NE 223RD AVE",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308554",
            "telephone_number": "503-491-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CSIGA",
        "first_name": "KERRY",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-27",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.