Individual provider Active NPI

Lesa Sherilyn Ingraham

  • Dental Assistant
  • Hillsboro, OR
National Provider Identifier
1982937306
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
A10270 Issued in OR
Practice address
19075 NW Tanasbourne Dr Ste 300
Hillsboro, OR 97124-5802
Phone
(503) 531-1700
Fax
(503) 531-1704
NPI assigned
Sep 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X A10270 OR Primary

Addresses

Primary practice location

19075 NW Tanasbourne Dr Ste 300
Hillsboro, OR 97124-5802

Mailing address

19075 NW Tanasbourne Dr Ste 300
Hillsboro, OR 97124-5802
Phone (503) 531-1700

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

LicenseStateTypeSpecialty
A10270ORMDDental Assistant

NPI Registry JSON

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253059200000",
    "number": "1982937306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19075 NW TANASBOURNE DR STE 300",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245802",
            "telephone_number": "503-531-1700",
            "fax_number": "503-531-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19075 NW TANASBOURNE DR STE 300",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245802",
            "telephone_number": "503-531-1700",
            "fax_number": "503-531-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAHAM",
        "first_name": "LESA",
        "middle_name": "SHERILYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2009-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "OR",
            "license": "A10270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.