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SALLY D WIEDEMAN RDH
NPI 1427420470
Dental Hygienist in Portland, OR

Active since October 28, 2015
12750 SE STARK ST BLDG E, PORTLAND, OR 97233(971) 347-3009(971) 256-3277 Get Directions Write a Review

NPPES record last updated: August 4, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 4, 2025, Aug 30, 2023, Jan 5, 2021 and 3 more (6 updates tracked since 2017).

About Sally D Wiedeman Rdh NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SALLY D WIEDEMAN RDH (NPI 1427420470) is an individual dental hygienist in Portland, Oregon, licensed in Oregon (H6804) and active in the NPI registry since October 2015.

NPPES Registry Identity

NPI1427420470
Entity TypeIndividualFemale
Primary Taxonomy124Q00000X
Provider Legal NameSALLY D WIEDEMANCredential: RDH
Location Address12750 SE STARK ST BLDG EPortland, OR 97233-1539
Mailing Address211 Se Caruthers StPortland, OR 97214-4502 · (503) 224-1044 · Fax (971) 260-0355
Phone(971) 347-3009
Fax(971) 256-3277
Sole ProprietorNo
Enumeration DateOctober 28, 2015
Last NPPES UpdateAugust 4, 20256 updates tracked since enumeration
NPPES CertifiedAugust 4, 2025
✔ NPI 1427420470 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDental HygienistDental Providers
Taxonomy Code124Q00000X
License✔ Licensed in OR · H6804
Definition
An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary.
12750 SE STARK ST BLDG E, Portland, OR 97233
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Other Identifiers 1

Medicaid500695952OR

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHAWNA LEBECHUCK-FISK DENTAL ASSISTANT
Dental Assistant
12750 SE STARK ST BLDG E
PORTLAND, OR 97233
Multnomah County (971) 347-3009
ACOSIA SIREWOP-LOPEZ DA
Dental Assistant
12750 SE STARK ST BLDG E
PORTLAND, OR 97233
Multnomah County (971) 347-3009
RACHEL J MORSETTE DA
Dental Assistant
12750 SE STARK ST BLDG E
PORTLAND, OR 97233
Multnomah County (971) 347-3009
JOURDAN L BURKLUND RDH
Dental Hygienist
12750 SE STARK ST BLDG E
PORTLAND, OR 97233
Multnomah County (971) 347-3009
LANAE D WASHBURN RDH
Dental Hygienist
12750 SE STARK ST BLDG E
PORTLAND, OR 97233
Multnomah County (971) 347-3009
PETER CLAIR ROBINSON WIDMER
Dental Assistant
12750 SE STARK ST BLDG E
PORTLAND, OR 97233
Multnomah County (971) 347-3009
NATIVE AMERICAN REHABILITATION ASSOC INC
Clinic/Center (Federally Qualified Health Center (FQHC))
12750 SE STARK ST BLDG E
PORTLAND, OR 97233
Multnomah County (971) 347-3009
SANTE L VAN METER DA
Dental Assistant
12750 SE STARK ST BLDG E
PORTLAND, OR 97233
Multnomah County (971) 347-3009

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sally Wiedeman's NPI number?

The NPI number for Sally Wiedeman is 1427420470. It was assigned to this individual provider in the NPPES registry on October 28, 2015.

Where is Sally Wiedeman located?

Sally Wiedeman practices at 12750 SE Stark St Bldg E, Portland, OR 97233. The listed phone number is (971) 347-3009.

What is Sally Wiedeman's specialty?

The primary specialty registered for this NPI is Dental Hygienist with taxonomy code 124Q00000X.

When was this NPI record last updated?

The NPPES record for Sally Wiedeman was last updated on August 4, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.