FAIROUZ CHOUIKH (NPI# 1407134596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407134596 |
| Entity Type | Individual |
| Full Name | FAIROUZ CHOUIKH |
| Credential | DMD |
| Practice Address |
2801 N Gantenbein Ave Portland OR 97227-1623 |
| Mailing Address |
982 Ave. Wilfrid-pelletier Apt. 304 Ste-foy QC G1W 4Y2 CA |
| Practice Telephone | 5034132200 |
| Enumeration Date | 2011-07-24 |
| Last Update Date | 2019-03-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
D10993 | OR | Dental Providers |
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2801 N GANTENBEIN AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227-1623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124027198 | James P Mccord | Pediatrics | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2005-07-20 |
| 1225639040 | Lina Rossetti-grulich | Nurse Practitioner | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2020-11-06 |
| 1033722673 | Karen Bronson | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2020-08-24 |
| 1356969331 | Sandy Hammer | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2020-07-07 |
| 1225673999 | Odaisa Igwe | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-11-16 |
| 1952945578 | Julie Lorine Hoover | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-11-06 |
| 1285278648 | Kate Harrell Unterberger | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-10-29 |
| 1780227082 | Keegan Carly Fritzke | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-10-21 |
| 1578106860 | Corinne Frohlick | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-10-20 |
| 1386287662 | Aimee Breitfelder Reddy | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-10-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
| 1851955975 | Erin Marie Staples | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave;, Suite 230, Portland, OR 97227 | 2019-04-24 |
| 1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
| 1730615071 | Mehran Giblin | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave, Suite 230, Legacy Clinic Emanuel, Portland, OR 97227 | 2017-05-05 |
| 1730623687 | Christina Grace Belter | Optometrist | 300 N Graham St Ste 300, Portland, OR 97227 | 2016-12-12 |
| 1407300205 | Jenna Abernathy | Counselor | 3537 N Williams Ave, Portland, OR 97227 | 2016-08-09 |
| 1215390760 | Tanya Marie Woods | Massage Therapist | 3808 N. Williams Ave., Portland, OR 97227 | 2016-04-01 |
| 1033596853 | Eric Allen Martin | Counselor | 2054 N. Vancouver Ave, Portland, OR 97227 | 2015-04-30 |
| 1285040436 | Berk Neurosurgical LLC | Neurological Surgery | 501 N Graham St Ste 500, Portland, OR 97227 | 2014-07-09 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536602 | Dario J Lapoma | Student in an Organized Health Care Education/Training Program | 1305 Se Birch St, Portland, OR 97214-5335 | 2020-10-18 |
| 1740888155 | Charles Samuel Goldfoot | Student in an Organized Health Care Education/Training Program | 1650 Nw 13th Ave Apt 109, Portland, OR 97209-3694 | 2020-10-16 |
| 1396343992 | Shelby Taylor Bowerly | Student in an Organized Health Care Education/Training Program | 4522 Ne Ainsworth St, Portland, OR 97218-1322 | 2020-10-15 |
| 1821696816 | Nancy Sierra Ferrer | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd # Or97239, Portland, OR 97239-3011 | 2020-10-13 |
| 1437757663 | David Gallacher | Student in an Organized Health Care Education/Training Program | 3303 S Bond Ave # 1, Portland, OR 97239-4501 | 2020-10-10 |
| 1366049777 | Carolyn Evans | Student in an Organized Health Care Education/Training Program | 80 Ne 14th Ave Apt 314, Portland, OR 97232-3568 | 2020-10-08 |
| 1669081659 | Amy Hill | Student in an Organized Health Care Education/Training Program | 3931 N Juneau St Apt 7, Portland, OR 97217-7419 | 2020-07-27 |
| 1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
| 1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
| 1558986364 | Haley Bosco Doyle | Student in an Organized Health Care Education/Training Program | 3587 Se Grant St, Portland, OR 97214-5829 | 2020-06-08 |
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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.