SANDRA J. BENNETT, DMD LLC (NPI# 1053586529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053586529 |
| Entity Type | Organization |
| Organization Name | SANDRA J. BENNETT, DMD LLC |
| Practice Address |
22400 Se Stark St Gresham OR 97030-2656 |
| Practice Telephone | 5036670438 |
| Practice Fax Number | 5036654870 |
| Mailing Telephone | 5036670438 |
| Mailing Fax Number | 5036654870 |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2008-04-25 |
| Authorized Official Name | DR. SANDRA J. BENNETT (OWNER) |
| Authorized Official Telephone | 5036670438 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SANDRA J. BENNETT, DMD LLC | 22400 Se Stark St, Ste 103, Gresham, OR 97030 |
| Street Address |
22400 SE STARK ST |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030-2656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821095597 | Ronald L Kerns | Optometrist | 22400 Se Stark St, Gresham, OR 97030-2656 | 2005-07-07 |
| 1336786953 | Okaeri Massage Therapy LLC | Mechanotherapist | 22400 Se Stark St, Gresham, OR 97030-2656 | 2019-12-02 |
| 1962048538 | Samantha Walker | Massage Therapist | 22400 Se Stark St, Gresham, OR 97030-2656 | 2019-11-19 |
| 1902440738 | Tina Gadzala Lmt | Clinic/Center | 22400 Se Stark St, Gresham, OR 97030-2656 | 2019-11-05 |
| 1275177628 | Lauren Sutton | Naturopath | 22400 Se Stark St, Gresham, OR 97030-2656 | 2019-10-29 |
| 1609340710 | Emily Anderson Steele | Naturopath | 22400 Se Stark St, Gresham, OR 97030-2656 | 2019-01-11 |
| 1225557549 | Christina Gadzala | Massage Therapist | 22400 Se Stark St, Gresham, OR 97030-2656 | 2017-09-19 |
| 1609228238 | Danielle | Massage Therapist | 22400 Se Stark St, Gresham, OR 97030-2656 | 2016-07-07 |
| 1194175638 | Katherine Zieman | Naturopath | 22400 Se Stark St, Suite 105, Gresham, OR 97030-2656 | 2016-06-15 |
| 1407283237 | Bridges Family Wellness PC | Clinic/Center | 22400 Se Stark St, Suite 105, Gresham, OR 97030-2656 | 2013-10-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174032312 | Tiffany Chen | Occupational Therapist | 304 Ne Hood Ave., Gresham, OR 97030 | 2017-09-20 |
| 1225568454 | Goldstar Vascular Access, Inc | Home Infusion | 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 | 2017-06-20 |
| 1861940454 | Jessica Morrow | Massage Therapist | 1748 Nw Fairview Dr., Gresham, OR 97030 | 2016-09-13 |
| 1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
| 1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
| 1992159610 | Kathleen Kline, Lmt | Massage Therapist | 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 | 2016-04-19 |
| 1215390109 | The Wallace Medical Concern | Nurse Practitioner | 254 Nw Burnside Road, Gresham, OR 97030 | 2016-03-30 |
| 1932568912 | Atchison Dialysis, LLC | Clinic/Center | 878 Nw Burnside Rd, Gresham, OR 97030 | 2016-02-18 |
| 1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
| 1992171730 | Melissa E Childs | Massage Therapist | 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 | 2015-08-17 |
| Find all providers in zip 97030 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508416041 | Columbia River Dentistry-gresham, LLC | Clinic/Center | 1700 Nw Civic Dr Ste 320, Gresham, OR 97030-3774 | 2019-09-17 |
| 1386012029 | Nw Headache Center, LLC | Clinic/Center | 1042 Nw Norman Ave Ste 210, Gresham, OR 97030-5554 | 2015-09-11 |
| 1619358256 | Harry D Chambers Dds PC | Clinic/Center | 21825 Se Stark St, Suite A, Gresham, OR 97030-2075 | 2015-06-09 |
| 1871999144 | Harmony Orthodontics, LLC | Clinic/Center | 742 Ne Division Street, Gresham, OR 97030 | 2014-11-13 |
| 1922609296 | Floyd Family Orthodontics Gresham, LLC | Clinic/Center | 1201 Se 223rd Ave Ste 220, Gresham, OR 97030-2578 | 2020-11-04 |
| 1881247039 | Benjamin T Russell Dmd LLC | Clinic/Center | 742 Ne Division St Ste 102, Gresham, OR 97030-3979 | 2019-07-17 |
| 1881195402 | Mulnomah County | Clinic/Center | 600 Ne 8th St, Gresham, OR 97030-7317 | 2018-02-28 |
| 1538614458 | Division Family Dental LLC | Clinic/Center | 2484 Ne Division St, Gresham, OR 97030-6020 | 2016-08-21 |
| 1871768853 | Daniel J Ries, Dmd, PC | Clinic/Center | 1201 Se 223rd Ave, Suite 140, Gresham, OR 97030-2574 | 2008-04-29 |
| 1770628976 | James R. Anderson Dmd, P.C. | Clinic/Center | 19059 Se Division St, Gresham, OR 97030-5165 | 2007-02-21 |
| Find all providers in GRESHAM | ||||
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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.