DR. JEREMY E ARCHIBALD (NPI# 1336352368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336352368 |
| Entity Type | Individual |
| Full Name | DR. JEREMY E ARCHIBALD |
| Credential | DDS |
| Practice Address |
742 Ne Division St Ste 101 Gresham OR 97030-3979 |
| Practice Telephone | 5036657017 |
| Practice Fax Number | 5036655135 |
| Mailing Telephone | 5036657017 |
| Mailing Fax Number | 5036655135 |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2016-03-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D8266 | OR | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013289578 | Jeremy John Archibald | Case Manager/Care Coordinator | 1118 Oak St Se, Salem, OR 97301-4019 | 2012-01-31 |
| Street Address |
742 NE DIVISION ST STE 101 |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030-3979 |
| 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 | 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 |
|---|---|---|---|---|
| 1124571369 | Main Street Dental | Dentist | 810 N Main Ave, Gresham, OR 97030-5538 | 2016-07-23 |
| 1003298605 | Ngan Hoang | Dentist | 670 Nw Eastman Pkwy, Gresham, OR 97030-7255 | 2015-06-19 |
| 1487990172 | Gresham Family Dentistry, PC | Dentist | 501 Ne Hood Ave Ste 333, Gresham, OR 97030-7346 | 2012-12-27 |
| 1508184839 | Mailiki L Patterson | Dentist | 2383 Se Meadow Ct, Gresham, OR 97080-9398 | 2010-05-11 |
| 1821256827 | Greene & Westermeyer PC | Dentist | 4255 Se 182nd Ave, Gresham, OR 97030 | 2008-05-27 |
| 1942478904 | Avenue Dental Care | Dentist | 1388 E Powell Blvd, Gresham, OR 97030-8004 | 2008-02-13 |
| 1841499696 | Michael L Mckeel | Dentist | 108 Ne Second, Gresham, OR 97030 | 2007-07-12 |
| 1629107123 | Fredrick C. Thompson | Dentist | 1867 Nw Civic Dr, Gresham, OR 97030-5566 | 2007-03-02 |
| 1427183110 | Brian L Allen | Dentist | 946 Ne Burnside, Gresham, OR 97030 | 2007-02-22 |
| 1902993694 | Gary L Fisher | Dentist | 320 Ne 5th St, Gresham, OR 97030 | 2006-10-06 |
| 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.