DR. KARL CUDDY (NPI# 1053864561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053864561 |
| Entity Type | Individual |
| Full Name | DR. KARL CUDDY |
| Credential | MD, DDS |
| Practice Address |
2801 N Gantenbein Ave Portland OR 97227-1623 |
| Practice Telephone | 5034134645 |
| Mailing Telephone | 5034134645 |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2016-08-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | FE177091 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
2801 N GANTENBEIN AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227-1623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124027198 | James P Mccord | Pediatrics | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2005-07-20 |
| 1225639040 | Lina Rossetti-grulich | Nurse Practitioner | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2020-11-06 |
| 1033722673 | Karen Bronson | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2020-08-24 |
| 1356969331 | Sandy Hammer | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2020-07-07 |
| 1225673999 | Odaisa Igwe | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-11-16 |
| 1952945578 | Julie Lorine Hoover | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-11-06 |
| 1285278648 | Kate Harrell Unterberger | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-10-29 |
| 1780227082 | Keegan Carly Fritzke | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-10-21 |
| 1578106860 | Corinne Frohlick | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-10-20 |
| 1386287662 | Aimee Breitfelder Reddy | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-10-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
| 1851955975 | Erin Marie Staples | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave;, Suite 230, Portland, OR 97227 | 2019-04-24 |
| 1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
| 1730615071 | Mehran Giblin | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave, Suite 230, Legacy Clinic Emanuel, Portland, OR 97227 | 2017-05-05 |
| 1730623687 | Christina Grace Belter | Optometrist | 300 N Graham St Ste 300, Portland, OR 97227 | 2016-12-12 |
| 1407300205 | Jenna Abernathy | Counselor | 3537 N Williams Ave, Portland, OR 97227 | 2016-08-09 |
| 1215390760 | Tanya Marie Woods | Massage Therapist | 3808 N. Williams Ave., Portland, OR 97227 | 2016-04-01 |
| 1033596853 | Eric Allen Martin | Counselor | 2054 N. Vancouver Ave, Portland, OR 97227 | 2015-04-30 |
| 1285040436 | Berk Neurosurgical LLC | Neurological Surgery | 501 N Graham St Ste 500, Portland, OR 97227 | 2014-07-09 |
| Find all providers in zip 97227 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346249281 | Bryce Earl Potter | Oral & Maxillofacial Surgery | 1849 Nw Kearney St, Ste 300, Portland, OR 97209-1453 | 2005-07-20 |
| 1104209386 | Felix Wiyanto Sim | Oral & Maxillofacial Surgery | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2015-07-07 |
| 1407109937 | Providence Health & Services - Oregon | Oral & Maxillofacial Surgery | 4805 Ne Glisan St, Suite 6n50, Portland, OR 97213-2933 | 2012-10-22 |
| 1447525852 | Brett A. Ueeck Dmd, Md, PC | Oral & Maxillofacial Surgery | 11786 Sw Barnes Rd Ste 110, Portland, OR 97225-5926 | 2012-03-19 |
| 1588939961 | Marcus Aaron Couey | Oral & Maxillofacial Surgery | 1849 Nw Kearney St Ste 300, Portland, OR 97209-1453 | 2012-03-18 |
| 1043537707 | Allen C Cheng | Oral & Maxillofacial Surgery | 1849 Nw Kearney St, Suite 300, Portland, OR 97209 | 2010-04-21 |
| 1043415870 | Ashish A Patel | Oral & Maxillofacial Surgery | 1849 Nw Kearney St, Suite 300, Portland, OR 97209 | 2007-06-20 |
| 1235332834 | Daniel Petrisor | Oral & Maxillofacial Surgery | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2007-06-09 |
| 1790889376 | Maine Medical Partners | Oral & Maxillofacial Surgery | 22 Bramhall St, Dept of Surgery, Portland, ME 04102-3134 | 2006-09-12 |
| 1841208303 | Thomas William Albert | Oral & Maxillofacial Surgery | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2006-08-03 |
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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.