HAWTHORNE DENTAL (NPI# 1114194818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114194818 |
| Entity Type | Organization |
| Organization Name | HAWTHORNE DENTAL |
| Practice Address |
4511 Se Hawthorne Blvd Ste 205 Portland OR 97215-3170 |
| Practice Telephone | 5032353002 |
| Practice Fax Number | 5032350084 |
| Mailing Telephone | 5032353002 |
| Mailing Fax Number | 5032350084 |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2008-05-12 |
| Authorized Official Name | KEITH EDWARD WATSON (DENTIST) |
| Authorized Official Telephone | 5032353002 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
8220 | OR | Dental Providers |
| Street Address |
4511 SE HAWTHORNE BLVD STE 205 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97215-3170 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932104825 | Jonna Elizabeth Hongo | Dentist | 4511 Se Hawthorne Blvd, Ste 110, Portland, OR 97215-3170 | 2005-06-16 |
| 1083154637 | Mindful Awakenings, LLC | Community/Behavioral Health | 4511 Se Hawthorne Blvd, Suite 204, Portland, OR 97215-3182 | 2017-03-01 |
| 1306394663 | Lauren Deisenroth Pmhnp-bc LLC | Clinic/Center | 4511 Se Hawthorne Blvd, Suite 215, Portland, OR 97215-3170 | 2016-09-15 |
| 1689065864 | Elin Katrina Allen | Dental Hygienist | 4511 Se Hawthorne Blvd, Ste 101, Portland, OR 97215-3170 | 2015-02-10 |
| 1881025872 | Travis Jonquil | Massage Therapist | 4511 Se Hawthorne Blvd, Suite 204, Portland, OR 97215-3170 | 2013-12-02 |
| 1669759767 | Heritage Dental | Clinic/Center | 4511 Se Hawthorne Blvd, Suite 101, Portland, OR 97215-3195 | 2011-11-03 |
| 1336434703 | Dr. Jonna E. Hongo | Clinic/Center | 4511 Se Hawthorne Blvd, Suite 110, Portland, OR 97215-3170 | 2011-06-14 |
| 1770886939 | Karina Marie Jarvela | Naturopath | 4511 Se Hawthorne Blvd, Suite 208, Portland, OR 97215 | 2010-12-09 |
| 1518106319 | Richard Justin Tooke | Dentist | 4511 Se Hawthorne Blvd, Portland, OR 97215-3170 | 2009-02-18 |
| 1174771703 | Charles Leroy Wilk | Acupuncturist | 4511 Se Hawthorne Blvd, Suite 214, Portland, OR 97215-3170 | 2008-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952926339 | Lisa Silverman | Counselor | 1835 Se 50th Avenue, Portland, OR 97215 | 2020-06-11 |
| 1003381195 | Darcie Leigh Juarez | Naturopath | 6118 Se Belmont St Ste 407, Portland, OR 97215 | 2018-10-04 |
| 1740710581 | Riley W Protz | Pharmacist | 5544 E Bursnide, Portland, OR 97215 | 2017-06-14 |
| 1114459088 | Genevieve Kathleen Shields | Registered Nurse | 5451 Se Belmont, Suite 100, Portland, OR 97215 | 2017-03-30 |
| 1205282514 | Aiyana Lucas | Social Worker | 4531 Se Belmont St Ste 310b, Portland, OR 97215 | 2016-05-05 |
| 1508223918 | Catherine Ann Chapman | Counselor | 422 Se 79th Street, Suite 202, Portland, OR 97215 | 2016-01-15 |
| 1518338854 | Cody Begdorian | Acupuncturist | 4220 Se Stark, Portland, OR 97215 | 2015-10-13 |
| 1588040653 | Corinne Leblanc | Acupuncturist | 2305 Se 50th Ave., Suite 200, Portland, OR 97215 | 2015-07-30 |
| 1942688544 | Casey Lynne Peters | Occupational Therapist | 6040 Se Belmont S, Portland, OR 97215 | 2015-05-14 |
| 1457743783 | David Alexander Gambill | Counselor | 8041 E Burnside St., Portland, OR 97215 | 2015-02-24 |
| Find all providers in zip 97215 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760097034 | Hannah Glazunov | Dentist | 4970 S Landing Dr Unit 302, Portland, OR 97239-5900 | 2020-09-13 |
| 1093345159 | Ashley Bennett Dds, LLC | Dentist | 5415 Sw Westgate Dr Ste 202, Portland, OR 97221-2429 | 2020-01-17 |
| 1841844354 | Carly K Christoferson | Dentist | 1616 Sw Sunset Blvd Ste A, Portland, OR 97239-2641 | 2019-08-01 |
| 1083279384 | Timber Dental Downtown LLC | Dentist | 310 Sw 4th Ave Ste 100, Portland, OR 97204-2345 | 2019-05-02 |
| 1780140715 | Timber Dental East Burnside | Dentist | 1200 Se Sandy Blvd, Portland, OR 97214-1347 | 2019-02-14 |
| 1548726581 | Timber Dental Bethany | Dentist | 15715 Nw Central Dr Ste 7-8, Portland, OR 97229-1267 | 2019-02-14 |
| 1124583208 | Portland Dental LLC | Dentist | 511 Sw 10th Ave Ste 1206, Portland, OR 97205-2713 | 2019-02-04 |
| 1245701465 | Jeffrey Levitt Brady | Dentist | 10060 E Burnside St, Portland, OR 97216-2334 | 2018-12-16 |
| 1780166918 | Daniel Alejandro Mesa | Dentist | 2038 Lloyd Ctr # H317, Portland, OR 97232-1309 | 2018-09-04 |
| 1093293375 | Trusha B Patel | Dentist | 3801 N Interstate Ave, Portland, OR 97227-1109 | 2018-07-30 |
| 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.