KELLEY STEWART WILSON (NPI# 1942224332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1942224332 |
Entity Type | Individual |
Full Name | KELLEY STEWART WILSON |
Other Name | KELLEY YVONNE STEWART |
Credential | DMD |
Practice Address |
5025 Se 28th Ave Portland OR 97202-4445 |
Mailing Address |
19075 Nw Tanasbourne Dr. #300 Sunset Dental Office Hillboro OR 97124 |
Practice Telephone | 5032384418 |
Practice Fax Number | 5032380360 |
Mailing Telephone | 5035311700 |
Mailing Fax Number | 5035311704 |
Enumeration Date | 2006-07-27 |
Last Update Date | 2011-09-07 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 122300000X | Dentist | D7960 | OR | Dental Providers |
Y | 1223G0001X |
Dentist Specialization: General Practice |
D7960 | OR | Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346605714 | Kelley Wilson | Psychologist | 1015 Montlimar Dr, Mobile, AL 36609-1713 | 2015-12-29 |
1295141109 | Kelley Anastasia Wilson | Dietitian, Registered | 750 University Row, Room 353, Madison, WI 53705-1311 | 2014-07-11 |
1104244474 | Kelley Wilson | Counselor | 5131 Manatee Ave W, Bradenton, FL 34209-3740 | 2014-04-02 |
1508085531 | Kelley Geddis Wilson | Nurse Practitioner | 4100 John R St, Karmanos Cancer Center Midlevels, Detroit, MI 48201-2013 | 2007-04-25 |
Street Address |
5025 SE 28TH AVE |
City | PORTLAND |
State | OR |
Zip Code | 97202-4445 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467477315 | Charles Calvert Rosson IIi | Dentist | 5025 Se 28th Ave, Portland, OR 97202-4445 | 2006-07-13 |
1225674757 | Sarah Bachman | Dental Assistant | 5025 Se 28th Ave, Portland, OR 97202-4445 | 2019-11-19 |
1275187189 | Jessica Leigh Jacobs | Dental Assistant | 5025 Se 28th Ave, Portland, OR 97202-4445 | 2019-07-29 |
1669998977 | Meghan Kathleen Toevs Duey | Dental Hygienist | 5025 Se 28th Ave, Portland, OR 97202-4445 | 2017-08-17 |
1235672049 | Nicole Lyemone Yeats | Dental Assistant | 5025 Se 28th Ave, Portland, OR 97202-4445 | 2016-11-28 |
1265984546 | Kaiser Foundation Health Plan of The Northwest | Dentist | 5025 Se 28th Ave, Portland, OR 97202-4445 | 2016-11-02 |
1821451394 | Keith Herkert | Dentist | 5025 Se 28th Ave, Portland, OR 97202-4445 | 2016-04-01 |
1841620507 | Sierra Brandon | Dental Hygienist | 5025 Se 28th Ave, Portland, OR 97202-4445 | 2013-11-17 |
1699105494 | Jessicah Marie Brick | Dental Hygienist | 5025 Se 28th Ave, Portland, OR 97202 | 2013-11-15 |
1245580497 | Jennifer Christine Mcguire | Dental Assistant | 5025 Se 28th Ave, Portland, OR 97202-4445 | 2012-09-14 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073143442 | Carewell LLC | Counselor | Portland River Park Center, 205 Se Spokane St Suite 358, Portland, OR 97202 | 2020-01-24 |
1588226765 | Melissa Lynn Hartley | Counselor | 1235 Se Division St. Suite 103, Portland, OR 97202 | 2019-07-08 |
1275192999 | Kimberly Rae Kilgore | Counselor | 5509 Se 22nd St #3a, Portland, OR 97202 | 2019-06-06 |
1639736069 | Kyra Steinhauer | Social Worker | 3145 Se Powell Blvd, Portland, OR 97202 | 2019-05-21 |
1134644321 | Bridgette Hennigsen | Social Worker | 3810 Se 11th Ave, Portland, OR 97202 | 2017-08-08 |
1558895789 | Lenore Cangeloso | Acupuncturist | 1235 Se Division Street, Suie 117, Portland, OR 97202 | 2017-04-14 |
1376099093 | Anna Christine Leclerc | Contractor | 2024 Se Clinton Street, Zenana Spa and Wellness Center, Portland, OR 97202 | 2016-09-01 |
1144684663 | Catholic Charities | Case Management | 2740 Se Powell Blvd., Portland, OR 97202 | 2016-04-11 |
1881082097 | Zoomcare Dental, P.C. | Dentist | 3130 Se Division Street, Building 2, Portland, OR 97202 | 2014-12-23 |
1124424700 | Jessica Nash | Counselor | 6411 Se 17th Ave, Portland, OR 97202 | 2014-11-10 |
Find all providers in zip 97202 |
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 |
---|---|---|---|---|
1760097034 | Hannah Glazunov | Dentist | 4970 S Landing Dr Unit 302, Portland, OR 97239-5900 | 2020-09-13 |
1093345159 | Ashley Bennett Dds, LLC | Dentist | 5415 Sw Westgate Dr Ste 202, Portland, OR 97221-2429 | 2020-01-17 |
1841844354 | Carly K Christoferson | Dentist | 1616 Sw Sunset Blvd Ste A, Portland, OR 97239-2641 | 2019-08-01 |
1083279384 | Timber Dental Downtown LLC | Dentist | 310 Sw 4th Ave Ste 100, Portland, OR 97204-2345 | 2019-05-02 |
1780140715 | Timber Dental East Burnside | Dentist | 1200 Se Sandy Blvd, Portland, OR 97214-1347 | 2019-02-14 |
1548726581 | Timber Dental Bethany | Dentist | 15715 Nw Central Dr Ste 7-8, Portland, OR 97229-1267 | 2019-02-14 |
1124583208 | Portland Dental LLC | Dentist | 511 Sw 10th Ave Ste 1206, Portland, OR 97205-2713 | 2019-02-04 |
1245701465 | Jeffrey Levitt Brady | Dentist | 10060 E Burnside St, Portland, OR 97216-2334 | 2018-12-16 |
1780166918 | Daniel Alejandro Mesa | Dentist | 2038 Lloyd Ctr # H317, Portland, OR 97232-1309 | 2018-09-04 |
1093293375 | Trusha B Patel | Dentist | 3801 N Interstate Ave, Portland, OR 97227-1109 | 2018-07-30 |
Find all providers in PORTLAND |
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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.