Individual provider Active NPI

Jonna Elizabeth Hongo, DMD

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1932104825
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5984 Issued in OR
Practice address
4511 SE Hawthorne Blvd
Ste 110
Portland, OR 97215-3170
Phone
(503) 656-8966
Fax
(503) 238-7022
NPI assigned
Jun 16, 2005
Last updated
Jun 14, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5984 OR Primary

Addresses

Primary practice location

4511 SE Hawthorne Blvd
Ste 110
Portland, OR 97215-3170

Mailing address

4511 SE Hawthorne Blvd
Ste 110
Portland, OR 97215-3170
Phone (503) 656-8966

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170519000120 OR Order and Referring Only - Maxillofacial SurgeryPractitioner - Maxillofacial Surgery 7517278609

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5984ORMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Jonna E. Hongo Past Accepting new patients

Organizations & group practices 1

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1932104825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 SE HAWTHORNE BLVD",
            "address_2": "STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972153170",
            "telephone_number": "503-656-8966",
            "fax_number": "503-238-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 SE HAWTHORNE BLVD",
            "address_2": "STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972153170",
            "telephone_number": "503-656-8966",
            "fax_number": "503-238-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONGO",
        "first_name": "JONNA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "5984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.