PORTLAND DENTAL SMILES (NPI# 1063065068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063065068 |
| Entity Type | Organization |
| Organization Name | PORTLAND DENTAL SMILES |
| Practice Address |
732 Sw 3rd Ave Ste 202 Portland OR 97204-2409 |
| Practice Telephone | 5035422580 |
| Practice Fax Number | 5032412565 |
| Mailing Telephone | 5035422580 |
| Mailing Fax Number | 5032412565 |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2019-07-18 |
| Authorized Official Name | CAMILLE DEWOLF (OFFICE MANAGER) |
| Authorized Official Telephone | 5035422580 |
| 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 | PORTLAND DENTAL SMILES LLC | 511 Sw 10th Ave, Suite 1114, Portland, OR 97205 |
| Street Address |
732 SW 3RD AVE STE 202 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97204-2409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922662352 | Sleep Management, L.L.C. | Respiratory Therapist, Registered | 1050 Sw 6th Avenue, Suite 1100 Office # 52, Portland, OR 97204 | 2019-05-01 |
| 1588178701 | Daniel Hendrickson | Pharmacist | 503 Sw 5th Avenue, Portland, OR 97204 | 2017-11-27 |
| 1790133031 | Modupe Desiree Bansile | Counselor | 209 Sw Fourth Ave, Suite 520, Portland, OR 97204 | 2016-05-26 |
| 1841655834 | Isabella Zaragoza | Counselor | 421 Sw Oak St Suite 520, Portland, OR 97204 | 2015-12-18 |
| 1952737736 | Hessler-cohen Enterprises LLC | Acupuncturist | 310 Sw 4rth Avenue, Suite 725, Portland, OR 97204 | 2013-09-24 |
| 1144583378 | Angela Nicole Johnson | Physical Therapist | 555 Sw Oak Street, Portland, OR 97204 | 2012-06-22 |
| 1255614624 | Jaclyn Rene Jones | Nurse Practitioner | 601 Sw 4th Ave, Portland, OR 97204 | 2011-09-22 |
| 1407148398 | Cristianne Paulsen | Dental Hygienist | 426 Sw Stark, 9th Floor, Portland, OR 97204 | 2011-05-10 |
| 1396928255 | Jessica L Hall | Counselor | 421 Sw Oak Street, Suite 520, Portland, OR 97204 | 2007-12-13 |
| 1699896274 | Julie Anne Oyemaja | Counselor | 421 Sw Oak St., Ste. 210, Portland, OR 97204 | 2007-04-02 |
| Find all providers in zip 97204 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003430711 | Md Portland LLC | Clinic/Center | 15 Middle St # A-c2, Portland, ME 04101-4881 | 2020-05-29 |
| 1598396350 | Roots Dental, Pllc | Clinic/Center | 191 Marginal Way Ste C, Portland, ME 04101-3387 | 2020-01-30 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1063993749 | Roots Dental Stark LLC | Clinic/Center | 16338 Se Stark St, Portland, OR 97233-3958 | 2018-08-22 |
| 1528546330 | Christopher Brady Dmd LLC | Clinic/Center | 4707 Ne 102nd Ave Ste A, Portland, OR 97220-3393 | 2018-08-02 |
| 1124511191 | Enk Dental PC | Clinic/Center | 6516 Ne Siskiyou St, Portland, OR 97213-4572 | 2018-06-13 |
| 1760997654 | Gary S Hongo Dmd, LLC | Clinic/Center | 9732 Se Washington St Ste H, Portland, OR 97216-8405 | 2017-12-13 |
| 1689183717 | Kai-uwe H. Hahn Dmd Dba Edelweiss Dental | Clinic/Center | 3503 N Lombard Street, Portland, OR 97217 | 2017-09-20 |
| 1962930362 | Alaniz Family & Cosmetic Dentistry, PC | Clinic/Center | 11701 Se Stark St, Portland, OR 97216-3759 | 2017-05-30 |
| 1902277551 | Hollywood Family Dentistry | Clinic/Center | 1735 Ne 40th Ave, Portland, OR 97212-5307 | 2015-10-08 |
| 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.