TUALATIN MODERN DENTISTRY,PC (NPI# 1437499852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437499852 |
| Entity Type | Organization |
| Organization Name | TUALATIN MODERN DENTISTRY,PC |
| Other Organization Name | TUALATIN MODERN DENTISTRY |
| Practice Address |
7017 Sw Nyberg Street Tualatin OR 97062 |
| Mailing Address |
17000 Redhill Avenue Irvine CA 92614 |
| Practice Telephone | 5036128736 |
| Practice Fax Number | 5036128737 |
| Mailing Telephone | 7148458890 |
| Mailing Fax Number | 9494741495 |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2013-12-31 |
| Authorized Official Name | TODD COCKRELL (OWNER, DMD) |
| Authorized Official Telephone | 5036128736 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| TUALATIN MODERN DENTISTRY | Doing Business As Name - Organization |
| Street Address |
7017 SW NYBERG STREET |
| City | TUALATIN |
| State | OR |
| Zip Code | 97062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467018739 | Activeedge Tualatin, LLP | Physical Therapist | 19150 Sw 90th Avenue, Suite 200, West Linn, OR 97062 | 2019-05-13 |
| 1932607934 | Naturalways Pediatrics | Clinic/Center | 18813 Sw Martiazzi Ave, Tualatin, OR 97062 | 2018-01-25 |
| 1831646280 | Elizabeth Erin Tafesse | Behavioral Analyst | 18765 Sw Boones Ferry Rd Suite 100, Tualatin, OR 97062 | 2016-09-01 |
| 1962851311 | Ana Mercedes Cerritos-sanchez | Community Health Worker | 19355 Sw 65th Ave Apt A5, Tualatin, OR 97062 | 2016-06-07 |
| 1952759318 | William Luke Summers | Counselor | 18840 Southwest Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2016-05-26 |
| 1730536913 | Krystle Alligood | Behavioral Analyst | 18768 Sw Boones Ferry Road, Tualatin, OR 97062 | 2016-05-18 |
| 1760869739 | Oregon City Medical Nw, Inc | Clinic/Center | 6464 Sw Borland Road #d-4, Tualatin, OR 97062 | 2015-04-29 |
| 1396148904 | Tracy Filley | Clinical Nurse Specialist | 18840 Sw Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2014-09-28 |
| 1043646474 | Michelle Lords | Registered Nurse | 7668 Sw Mohawk Street, Tualatin, OR 97062 | 2013-09-17 |
| 1871930750 | Sharon Ruth Frank | Social Worker | 7668 Sw Mohawk St., Aps Healthcare, Tualatin, OR 97062 | 2013-05-31 |
| Find all providers in zip 97062 | ||||
| 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 |
|---|---|---|---|---|
| 1366737587 | Rick A. Matthias | Dentist | 18925 Sw 84th Ave, Tualatin, OR 97062-9477 | 2011-06-15 |
| 1447446737 | Renee L Weichel Dmd PC | Dentist | 18761 Sw Martina Avenue, Tualatin, OR 97062 | 2007-09-20 |
| 1811104300 | Victoria Nan Moore | Dentist | 21352 Sw Makah Ct, Tualatin, OR 97062-9309 | 2007-05-16 |
| 1720104946 | Renee Lynne Weichel | Dentist | 18761 Sw Martinazzi Ave, Tualatin, OR 97062-6808 | 2007-03-21 |
| 1043369598 | Edward D. Lacy, Dmd. Fagd, PC | Dentist | 8220 Sw Warm Springs St, Suite 200, Tualatin, OR 97062-9097 | 2007-01-10 |
| 1386758845 | Rick A Evans | Dentist | 8225 Sw Tualatin Sherwood Rd, Tualatin, OR 97062-8441 | 2006-08-19 |
| 1366474678 | William Jordan | Dentist | 18789 Sw Boones Ferry Rd, Ste 4, Tualatin, OR 97062-8412 | 2006-07-07 |
| 1710947494 | Ian Pham | Dentist | 18791 Sw Boones Ferry Rd, Suite 3, Tualatin, OR 97062-8412 | 2006-03-25 |
| 1780682526 | Candace L Peterson | Dentist | 18795 Sw Boones Ferry Rd, Tualatin, OR 97062-8412 | 2005-07-13 |
| 1144228602 | Pari Samani | Dentist | 8375 Sw Warm Springs St, Tualatin, OR 97062-9003 | 2005-07-08 |
| Find all providers in TUALATIN | ||||
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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.