DR. MASTANEH POURNADERI (NPI# 1063729523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063729523 |
| Entity Type | Individual |
| Full Name | DR. MASTANEH POURNADERI |
| Credential | D.D.S |
| Practice Address |
12710 Se Division St Portland OR 97236-3134 |
| Mailing Address |
14820 Nw Tranquility Dr Banks OR 97106-8835 |
| Practice Telephone | 5039883410 |
| Mailing Telephone | 5033240631 |
| Enumeration Date | 2010-09-04 |
| Last Update Date | 2010-09-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 42083 | CA | Dental Providers |
| Y | 122300000X | Dentist | D8516 | OR | Dental Providers |
| Street Address |
12710 SE DIVISION ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97236-3134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447298260 | Mary E Meadows | Family Medicine | 12710 Se Division St, Portland, OR 97236-3134 | 2006-06-03 |
| 1588281240 | Janet Trang Do | Pharmacist | 12710 Se Division St, Portland, OR 97236-3134 | 2020-06-29 |
| 1033759212 | Derrick Michael Jones | Physician Assistant | 12710 Se Division St, Portland, OR 97236-3134 | 2020-01-15 |
| 1447893383 | Krista Kaufman | Nurse Practitioner | 12710 Se Division St, Portland, OR 97236-3134 | 2019-10-23 |
| 1174170682 | Amy Samantha Peck | Nurse Practitioner | 12710 Se Division St, Portland, OR 97236-3134 | 2019-08-20 |
| 1841776598 | Stephen Lawrence Erwin | Dentist | 12710 Se Division St, Portland, OR 97236-3134 | 2018-07-16 |
| 1083115612 | Multnomah County | Clinic/Center | 12710 Se Division St, Portland, OR 97236-3134 | 2018-02-28 |
| 1306394549 | Multnomah County Health Department | Clinic/Center | 12710 Se Division St, Portland, OR 97236-3134 | 2016-09-16 |
| 1952859555 | Neema Mohammad Nader | Nurse Practitioner | 12710 Se Division St, Portland, OR 97236-3134 | 2016-09-13 |
| 1447707625 | Margot Presley | Nurse Practitioner | 12710 Se Division St, Portland, OR 97236-3134 | 2016-09-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336650357 | Wondmimu Edao Chako | Registered Nurse | 3708 Se 144th Avenue, Portland, OR 97236 | 2017-10-17 |
| 1881142388 | John Ho | Pharmacist | 14700 Se Division St., Portland, OR 97236 | 2016-09-14 |
| 1306392527 | Lori-ann Lima | Nurse Practitioner | Multnomah County Health Department- Mid Cty Health Ctr, 12710 Se Division St, Portland, OR 97236 | 2016-08-28 |
| 1982096202 | Allan Fitzpatrick Beals-gibson | Adult Companion | 15602 Se Division St., Portland, OR 97236 | 2015-02-24 |
| 1386047132 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3530 Se 136th Ave. #5, Portland, OR 97236 | 2014-10-07 |
| 1356750319 | Kendra Harding | Counselor | 17214 Se Division Street, Portland, OR 97236 | 2014-08-04 |
| 1659790400 | Nghia Tran | Pharmacist | 8438 Se 138th Dr, Portland, OR 97236 | 2014-04-09 |
| 1942623764 | Laurel Katherine Hallock Koppelman | Nurse Practitioner | 12720 Se Division Street, Portland, OR 97236 | 2014-01-30 |
| 1982046249 | Victoria D Lathrop | Massage Therapist | 17221 Se Divistion St S-21, Portland, OR 97236 | 2013-07-26 |
| 1669819694 | Ariann Von Vaughn | Dental Hygienist | 18011 Se Pershing Ct, Portland, OR 97236 | 2013-05-31 |
| Find all providers in zip 97236 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366064 | Felipe Gregorio Flores | Dentist | 107 Shorecliff Dr, Portland, TX 78374-1459 | 2020-11-02 |
| 1972117588 | Medical Teams International | Dentist | 14150 Sw Milton Ct, Portland, OR 97224-8024 | 2020-09-01 |
| 1255975561 | Michigan Sleep Solutions LLC | Dentist | 8037 Abbey Rd., Portland, MI 48875-9774 | 2019-10-30 |
| 1073162699 | Ryan Douglas Mccormick | Dentist | 3620 Se Powell Blvd Ste 200, Portland, OR 97202-1880 | 2019-09-06 |
| 1255989497 | Owen Ritter Lund | Dentist | 4224 Ne Halsey St Ste 330, Portland, OR 97213-1568 | 2019-08-30 |
| 1023663119 | Xiaochen Zhou | Dentist | 2824 Ne Wasco St Ste 200, Portland, OR 97232-1772 | 2019-08-06 |
| 1598223919 | Portland Modern Dentistry | Dentist | 5175 Ne Martin Luther King Blvd Ste 110, Portland, OR 97211-3233 | 2019-03-05 |
| 1922571942 | Rashmi, LLC | Dentist | 553 Portland Cobalt Rd Unit 1, Portland, CT 06480-1968 | 2019-01-03 |
| 1053891051 | Waleed Almulla | Dentist | 8401 Ne Halsey St Ste 102, Portland, OR 97220-5670 | 2018-08-19 |
| 1558848333 | Kelsey Mcevoy | Dentist | 11805 Nw Cedar Falls Dr Ste 101, Portland, OR 97229-2780 | 2018-07-24 |
| 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.