MS. JOLENE MOURITSEN (NPI# 1609089606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609089606 |
| Entity Type | Individual |
| Full Name | MS. JOLENE MOURITSEN |
| Credential | EFDA |
| Practice Address |
5135 Skyline Rd. S. Salem OR 97306 |
| Mailing Address |
4892 Liberty Rd. S. #177 Salem OR 97306 |
| Practice Telephone | 5035886560 |
| Mailing Telephone | 5033789404 |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 126800000X | Dental Assistant | 114153 | OR | Dental Providers |
| Street Address |
5135 SKYLINE RD. S. |
| City | SALEM |
| State | OR |
| Zip Code | 97306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922137504 | Charlene Garbutt | Dental Assistant | 5135 Skyline Rd. S., Salem, OR 97306 | 2007-03-02 |
| 1932238128 | Judith Francine Jackson | Dental Assistant | 5135 Skyline Rd. S., Salem, OR 97306 | 2007-03-05 |
| 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 |
| 1417085747 | Michelle West | Dental Assistant | 5135 Skyline R S, Salem, OR 97306 | 2007-02-28 |
| 1457447930 | Sandra Renee Albert | Technician/Technologist | 5125 Skyline Rd Se, Salem, OR 97306 | 2006-10-04 |
| Find all providers in zip 97306 | ||||
| Taxonomy Code | 126800000X |
| Grouping | Dental Providers |
| Classification | Dental Assistant |
| An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134609050 | Andrea P Merryman | Dental Assistant | 5135 Skyline Rd South, Salem, OR 97306 | 2018-08-20 |
| 1245590553 | Thora Jane Stacy | Dental Assistant | 2300 N.e. Lacncaster Dr., Salem, OR 97303 | 2012-05-21 |
| 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 |
| 1295366698 | Noeun Nom | Dental Assistant | 2300 Lancaster Dr Ne, Salem, OR 97305-1223 | 2020-02-04 |
| 1427689843 | Cynthia Younkin | Dental Assistant | 2300 Lancaster Dr Ne, Salem, OR 97305-1223 | 2020-02-04 |
| 1629608070 | Lisa Renea Carr | Dental Assistant | 2400 Lancaster Dr Ne, Salem, OR 97305-1221 | 2020-01-23 |
| 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 |
| 1356981203 | Sharon Kay Rice | Dental Assistant | 2300 Lancaster Dr Ne, Salem, OR 97305-1223 | 2020-01-08 |
| 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.