Individual provider Active NPI

Patrick Arden Sherrard, D.M.D.

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1952478356
Registry record updated May 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7344 Issued in OR
Practice address
9053 SW Beaverton Hillsdale Hwy
Portland, OR 97225-2435
Phone
(503) 246-4712
Fax
(503) 246-0853
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2019

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 D7344 OR Primary

Addresses

Primary practice location

9053 SW Beaverton Hillsdale Hwy
Portland, OR 97225-2435

Mailing address

9053 SW Beaverton Hillsdale Hwy
Portland, OR 97225-2435
Phone (503) 246-4712

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
I20150918002213 OR Order and Referring Only - DentistPractitioner - Dentist 6800103102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D7344ORMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1952478356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9053 SW BEAVERTON HILLSDALE HWY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972252435",
            "telephone_number": "503-246-4712",
            "fax_number": "503-246-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9053 SW BEAVERTON HILLSDALE HWY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972252435",
            "telephone_number": "503-246-4712",
            "fax_number": "503-246-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERRARD",
        "first_name": "PATRICK",
        "middle_name": "ARDEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.