DR. GREGORY PEARY STAFFORD (NPI# 1396751475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396751475 |
| Entity Type | Individual |
| Full Name | DR. GREGORY PEARY STAFFORD |
| Credential | DDS |
| Practice Address |
10102 Ne Glisan St Portland OR 97220-4456 |
| Mailing Address |
6325 Sw Elm Ave Beaverton OR 97005-4218 |
| Practice Telephone | 5032575959 |
| Practice Fax Number | 5034081472 |
| Mailing Telephone | 5036267826 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DEOOOO6891 | WA | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D6558 | OR | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316965940 | Gregory Lynn Stafford | Chiropractor | 1420 Shaw Ave Ste 103, Clovis, CA 93611-4072 | 2006-07-18 |
| 1710085907 | Gregory L Stafford | Dentist | 623 Main St, Little Rock, AR 72201-4201 | 2006-09-20 |
| 1922053164 | Gregory Lee Stafford | Physician Assistant | 1502 N Jefferson St, Attn: Jean Steele, Carrollton, MO 64633-1948 | 2006-05-24 |
| Street Address |
10102 NE GLISAN ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97220-4456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134177934 | David M. Teeter | Dentist | 10102 Ne Glisan St, Portland, OR 97220-4456 | 2006-05-04 |
| 1093328726 | Leah Dixon | Dental Assistant | 10102 Ne Glisan St, Portland, OR 97220-4456 | 2020-08-24 |
| 1871155358 | Sarah Nicole Bulkley | Dental Assistant | 10102 Ne Glisan St, Portland, OR 97220-4456 | 2019-07-03 |
| 1477026466 | Bethany Kay Wynn | Dental Assistant | 10102 Ne Glisan St, Portland, OR 97220-4456 | 2019-01-02 |
| 1255821575 | Yian Jan Huddleston | Dental Hygienist | 10102 Ne Glisan St, Portland, OR 97220-4456 | 2018-05-11 |
| 1144718040 | Diana Ngoc Dang | Dental Assistant | 10102 Ne Glisan St, Portland, OR 97220-4456 | 2018-04-25 |
| 1689176026 | Marina N Globak | Dental Assistant | 10102 Ne Glisan St, Portland, OR 97220-4456 | 2018-03-01 |
| 1629577580 | Denyl Elizabeth Decker | Dental Assistant | 10102 Ne Glisan St, Portland, OR 97220-4456 | 2018-02-06 |
| 1356879183 | Anneda May Ormae | Dental Assistant | 10102 Ne Glisan St, Portland, OR 97220-4456 | 2017-05-24 |
| 1194253971 | Alexis Nichole Kikes | Dental Assistant | 10102 Ne Glisan St, Portland, OR 97220-4456 | 2017-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
| 1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
| 1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
| 1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
| 1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
| Find all providers in zip 97220 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700374154 | Fox Kids Dentistry & Orthodontics II | Dentist | 1401 Se Morrison St Ste 120, Portland, OR 97214-2777 | 2018-05-01 |
| 1679924526 | Pediatric Dentistry of Portland LLC | Dentist | 2811 Ne Wasco St, Portland, OR 97232-1771 | 2016-06-22 |
| 1801183488 | World of Smiles, Pediatric Dentistry LLC | Dentist | 11790 Sw Barnes Rd Ste 280, Portland, OR 97225-5935 | 2011-07-05 |
| 1265696629 | Angela Dawn Boydston | Dentist | 2824 Ne Wasco St Ste 230, Portland, OR 97232-1772 | 2008-07-15 |
| 1972639623 | Anastacia M. Whitman | Dentist | 4548 N Albina Ave, Portland, OR 97217-3010 | 2007-02-26 |
| 1114088705 | Michael Biermann | Dentist | 5900 N Lombard St, Portland, OR 97203-4118 | 2006-12-13 |
| 1053408005 | Peter John Lax | Dentist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2006-10-09 |
| 1376646901 | Krista V Badger Dds PC | Dentist | 3839 Ne Tillamook St, Portland, OR 97212-5338 | 2006-09-07 |
| 1902827199 | Karole H Wilson D.m.d., PC | Dentist | 9370 Sw Greenburg Rd Ste T, Portland, OR 97223-5408 | 2006-07-22 |
| 1083650436 | Susan J Russett-collett | Dentist | 888 Brighton Ave, Portland, ME 04102-1004 | 2006-06-22 |
| 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.