WORLD OF SMILES TEEN DENTISTRY LLC (NPI# 1376068478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376068478 |
| Entity Type | Organization |
| Organization Name | WORLD OF SMILES TEEN DENTISTRY LLC |
| Practice Address |
11790 Sw Barnes Rd Ste 220 Portland OR 97225-5934 |
| Mailing Address |
4548 N Albina Ave Portland OR 97217-3010 |
| Practice Telephone | 5036269700 |
| Practice Fax Number | 5036269772 |
| Mailing Telephone | 5036269711 |
| Mailing Fax Number | 5038948869 |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2017-08-09 |
| Authorized Official Name | WENDI TJOSTOLVSON (PATIENT FINANCIAL COORDINATOR) |
| Authorized Official Telephone | 5036269711 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D9074 | OR | Dental Providers |
| Street Address |
11790 SW BARNES RD STE 220 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-5934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| 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.