KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (NPI# 1144772377) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144772377 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST |
| Other Organization Name | SKYLINE DENTAL OFFICE |
| Practice Address |
5135 Skyline Rd S Salem OR 97306-9427 |
| Mailing Address |
500 Ne Multnomah St Portland OR 97232-2023 |
| Practice Telephone | 8008132000 |
| Practice Fax Number | 5032866879 |
| Mailing Telephone | 8008132000 |
| Mailing Fax Number | 5032866879 |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2016-11-04 |
| Authorized Official Name | MR. KENNETH R WRIGHT (VP DENTAL CARE SERVICES) |
| Authorized Official Telephone | 5038134660 |
| Is Organization Subpart | Y |
| Parent Organization Name | KAISER PERMANENTE DENTAL CARE PROGRAM |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Skyline Dental Office | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588153076 | Kaiser Foundation Health Plan of The Northwest | Clinic/Center | 3060 Se Hawthorne Blvd, Portland, OR 97214-4121 | 2018-05-09 |
| 1992242093 | Kaiser Foundation Health Plan of The Northwest | Dentist | 12450 Sw Walker Rd, Beaverton, OR 97005-1401 | 2017-01-26 |
| 1801333901 | Kaiser Foundation Health Plan of The Northwest | General Practice | 3175 Nw Aloclek Dr, Hillsboro, OR 97124-7135 | 2017-01-26 |
| 1790113371 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 1230 7th Ave., Longview, WA 98682 | 2013-10-17 |
| 1093142234 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 1700 Ne 102nd Ave., Portland, OR 97220 | 2013-10-02 |
| 1427346543 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 5381 E Main St, Hillsboro, OR 97123-6447 | 2011-07-11 |
| 1215976014 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 5717 Ne 138th Ave, Portland, OR 97230-3409 | 2006-06-06 |
| 1801834510 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 2400 Lancaster Dr Ne, Salem, OR 97305-1221 | 2006-06-03 |
| 1568418051 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 7705 Se Division St, Portland, OR 97206-1059 | 2006-05-26 |
| 1962456194 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 5725 Ne 138th Ave, Portland, OR 97230-3409 | 2006-05-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | One Kaiser Plaza, Oakland, CA 94612 |
| Washington State Corporations | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | One Kaiser Plaza, Oakland, CA 94612 |
| Street Address |
5135 SKYLINE RD S |
| City | SALEM |
| State | OR |
| Zip Code | 97306-9427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407877996 | Jennifer M Harms | Dentist | 5135 Skyline Rd S, Salem, OR 97306-9427 | 2006-07-21 |
| 1285264978 | Stacy Marie Dunnihoo | Dental Assistant | 5135 Skyline Rd S, Salem, OR 97306-9427 | 2020-01-22 |
| 1407486558 | Heidi Kae Mort | Dental Assistant | 5135 Skyline Rd S, Salem, OR 97306-9427 | 2020-01-16 |
| 1346705647 | Alina Ferguson | Dental Assistant | 5135 Skyline Rd S, Salem, OR 97306-9427 | 2019-01-31 |
| 1336640655 | Valarie Marie Pardee | Dental Assistant | 5135 Skyline Rd S, Salem, OR 97306-9427 | 2018-02-22 |
| 1427576081 | Emily Irene Day | Dental Assistant | 5135 Skyline Rd S, Salem, OR 97306-9427 | 2017-09-05 |
| 1265894349 | Nicole Sequoia | Dental Assistant | 5135 Skyline Rd S, Salem, OR 97306-9427 | 2016-03-28 |
| 1417319948 | Alicia Buen | Dental Assistant | 5135 Skyline Rd S, Salem, OR 97306-9427 | 2016-03-23 |
| 1447640875 | Lauren Grace Maerz | Dental Hygienist | 5135 Skyline Rd S, Salem, OR 97306-9427 | 2015-01-22 |
| 1447651799 | Katherine Johnson | Physical Therapist | 5135 Skyline Rd S, Salem, OR 97306-9427 | 2014-09-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134609050 | Andrea P Merryman | Dental Assistant | 5135 Skyline Rd South, Salem, OR 97306 | 2018-08-20 |
| 1215470315 | Anthony Quoc Ngo | Nurse Practitioner | 5050 Skyline Village Loop, Salem, OR 97306 | 2016-11-22 |
| 1134521305 | Wendy Poling | Occupational Therapy Assistant | 1966 Madras St Se Apt 1082, Salem, OR 97306 | 2014-09-19 |
| 1659601045 | Monarch Medical Group LLC | Clinic/Center | 5686 Commercial St Se, Suite 100, Salem, OR 97306 | 2010-01-06 |
| 1316188006 | Judith A Mitchell | Physician Assistant | 4999 Skyline Rd. S., Salem, OR 97306 | 2009-03-10 |
| 1164685574 | Leon Chira | Pharmacist | 2431 Concomly Rd S, Salem, OR 97306 | 2008-07-07 |
| 1912175035 | Salem Clinic, PC | General Practice | 2531 Boone Road Se, Salem, OR 97306 | 2008-02-11 |
| 1326257486 | Robert Allen Long | Physical Therapist | 6250 Commercial St N.e., Salem, OR 97306 | 2007-05-22 |
| 1922137504 | Charlene Garbutt | Dental Assistant | 5135 Skyline Rd. S., Salem, OR 97306 | 2007-03-02 |
| 1417085747 | Michelle West | Dental Assistant | 5135 Skyline R S, Salem, OR 97306 | 2007-02-28 |
| Find all providers in zip 97306 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811557457 | Chadi Farag | Dentist | 25620 75th Street, Salem, WI 53168 | 2019-06-17 |
| 1528626660 | Stephanie Danielle Gibbons | Dentist | 5 Dawn St, Salem, NH 03079-3231 | 2019-06-04 |
| 1407414642 | Selma Moon Pierce | Dentist | 961 Glen Eden Ct Nw, Salem, OR 97304-2258 | 2019-06-03 |
| 1295392926 | Brock Jesse Nelson | Dentist | 631 Jason St Ne Ste 150, Salem, OR 97301-2750 | 2019-05-29 |
| 1023595899 | Gregory Lee Miller | Dentist | 3405 Derr Park Rd Se, Salem, OR 97310-0001 | 2018-07-25 |
| 1437643616 | Idylwood Dental LLC | Dentist | 4392 Liberty Road, Salem, OR 97302-6171 | 2018-06-20 |
| 1619428281 | William D. Bateman, Dmd, LLC | Dentist | 1995 Commercial St Se Ste 200, Salem, OR 97302-5291 | 2016-10-19 |
| 1134545494 | Caroline Wallace | Dentist | 103 S Colorado St, Salem, VA 24153-3848 | 2014-03-11 |
| 1275960296 | Amy Trevor | Dentist | 1595 Commercial St. Se, Salem, OR 97302 | 2013-10-04 |
| 1558601385 | Crisdental East Salem, LLC | Dentist | 3545 Lancaster Dr Ne, Salem, OR 97305-1435 | 2013-02-14 |
| Find all providers in SALEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.