Active NPI
Marina V Poliashov, RDH
- Dental Hygienist
- Portland, OR
National Provider Identifier
1942559596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- H7006
- Practice address
- 10102 NE Glisan St
Portland, OR 97220 - Phone
- (503) 238-4418
- NPI assigned
- Aug 29, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 117669 | OR | |
| Dental Hygienist | 124Q00000X | H7006 | OR | Primary |
Addresses
Primary practice location
10102 NE Glisan St
Portland, OR 97220
Mailing address
16038 SE Nehalem St
Portland, OR 97236-5387
Phone (503) 473-7778
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| H7006 | Other | OR | OREGON BOARD OF DENTISTRY |
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 |
|---|---|---|---|
| H7006 | OR | MD | Dental Hygienist |
| 117669 | OR | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526342400000",
"number": "1942559596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16038 SE NEHALEM ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972365387",
"telephone_number": "503-473-7778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10102 NE GLISAN ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97220",
"telephone_number": "503-238-4418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLIASHOV",
"first_name": "MARINA",
"middle_name": "V",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-29",
"last_updated": "2018-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "OR",
"license": "117669",
"primary": false
},
{
"code": "124Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dental Hygienist",
"state": "OR",
"license": "H7006",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON BOARD OF DENTISTRY",
"identifier": "H7006",
"state": "OR"
}
],
"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 May 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.