Individual provider Active NPI

Brenden Bell, DDS

  • Dentist
  • Lake Oswego, OR
National Provider Identifier
1952736555
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D10003 Issued in OR
Practice address
15962 Boones Ferry Rd Ste 105
Lake Oswego, OR 97035-4359
Phone
(509) 540-9369
NPI assigned
Sep 13, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 62918 CA
Dentist 122300000X D10003 OR Primary

Addresses

Primary practice location

15962 Boones Ferry Rd Ste 105
Lake Oswego, OR 97035-4359

Mailing address

15962 Boones Ferry Rd Ste 105
Lake Oswego, OR 97035-4359

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
I20160125001990 OR Order and Referring Only - DentistPractitioner - Dentist 6608179643

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D10003ORMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1952736555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15962 BOONES FERRY RD STE 105",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15962 BOONES FERRY RD STE 105",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354359",
            "telephone_number": "509-540-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELL",
        "first_name": "BRENDEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-13",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62918",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.