WILLAMETTE DENTAL GROUP (NPI# 1457763195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457763195 |
| Entity Type | Organization |
| Organization Name | WILLAMETTE DENTAL GROUP |
| Practice Address |
4925 Sw Griffith Dr Beaverton OR 97005-2923 |
| Practice Telephone | 5034441822 |
| Mailing Telephone | 5034441822 |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2014-05-29 |
| Authorized Official Name | LINDSEY KATHLEEN REEVES (DENTAL HYGIENIST) |
| Authorized Official Telephone | 5034441822 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 302R00000X | Health Maintenance Organization | H6635 | OR | Managed Care Organizations |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992182026 | Willamette Dental Group | Dentist | 3490 Lancaster Dr Ne, Salem, OR 97305-1356 | 2015-04-27 |
| 1972919496 | Willamette Dental Group | Exclusive Provider Organization | 1200 Chesterly Dr, Yakima, WA 98902-7338 | 2014-07-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WILLAMETTE DENTAL GROUP, P.C. | 6950 Ne Campus Way, Hillsboro, OR 97124-5611 |
| Oregon Corporations, Companies and Business Names | WILLAMETTE DENTAL GROUP, P.C. | 6950 Ne Campus Way, Hillsboro, OR 97124 |
| Washington State Corporations | WILLAMETTE DENTAL GROUP, P.C. | 6950 Ne Campus Way, Hillsboro, OR 97124-5611 |
| Street Address |
4925 SW GRIFFITH DR |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97005-2923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447361381 | Gary V. Dixon | Dentist | 4925 Sw Griffith Dr, Beaverton, OR 97005-2923 | 2006-08-31 |
| 1013568294 | Jonathan Juyun Kim | Dentist | 4925 Sw Griffith Dr, Beaverton, OR 97005-2923 | 2019-09-27 |
| 1932752581 | Yuzhu Lin | Dentist | 4925 Sw Griffith Dr, Beaverton, OR 97005-2923 | 2019-07-23 |
| 1376105858 | Yashar Sekhavatmandi | Dentist | 4925 Sw Griffith Dr, Beaverton, OR 97005-2923 | 2019-07-03 |
| 1437632692 | Diana Reyes Lee | Dentist | 4925 Sw Griffith Dr, Beaverton, OR 97005-2923 | 2018-09-12 |
| 1659867349 | Michael Lindsay | Dentist | 4925 Sw Griffith Dr, Beaverton, OR 97005-2923 | 2018-07-05 |
| 1982123014 | Amanda Jo Yoder | Dental Hygienist | 4925 Sw Griffith Dr, Beaverton, OR 97005-2923 | 2017-09-09 |
| 1861845729 | Kayla Marie Walters | Dentist | 4925 Sw Griffith Dr, Beaverton, OR 97005-2923 | 2016-07-15 |
| 1003268319 | Catherine Bom Kim | Dentist | 4925 Sw Griffith Dr, Beaverton, OR 97005-2923 | 2016-07-11 |
| 1932568474 | Franklin A Nguyen | Dental Hygienist | 4925 Sw Griffith Dr, Beaverton, OR 97005-2923 | 2016-02-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945053 | Krista Lowe Schimmelbusch | Student in an Organized Health Care Education/Training Program | 12730 Sw 3rd St., Beaverton, OR 97005 | 2020-06-05 |
| 1346882578 | Mireya Elissa Nunez I | Counselor | 12665 Sw Center Street, Suite 100, Beaverton, OR 97005 | 2019-10-09 |
| 1548816879 | Logan James Patzlaff | Behavior Technician | 6200 Sw Artic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-08-13 |
| 1528521424 | Alex Taylor Foerman | Behavior Technician | 6200 Sw Arctic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-04-09 |
| 1285193003 | Hazelnut Dental LLC | Clinic/Center | 10773 Sw Beaverton-hillsdale Hwy, Ste B, Beaverton, OR 97005 | 2019-03-19 |
| 1992286348 | Kathryn Wallner | Counselor | 14205 Sw Farmington Road, Suite 160, Beaverton, OR 97005 | 2018-08-23 |
| 1699265058 | Meaghan Mikulic | Social Worker | 14355 Sw Allen Blvd Suite 150, Beaverton, OR 97005 | 2018-05-11 |
| 1629568936 | Aimee J Nelson | Massage Therapist | 10700 Sw Beaverton Hillsdale Hwy Ste 465, Beaverton, OR 97005 | 2018-05-11 |
| 1093221780 | Ember Dahl | Massage Therapist | 12655 Sw Center St Ste 530, Beaverton, OR 97005 | 2017-12-18 |
| 1033667456 | Andre Vo | Pharmacist | 2575 Sw Walker Rd, Beaverton, OR 97005 | 2016-09-14 |
| Find all providers in zip 97005 | ||||
| Taxonomy Code | 302R00000X |
| Grouping | Managed Care Organizations |
| Classification | Health Maintenance Organization |
| (1) A form of health insurance in which its members prepay a premium for the HMO’s health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model. |
| Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 20; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922490739 | Molly Hamilton Lmt | Health Maintenance Organization | 9415 Sw 125th Ave Apt 2, Beaverton, OR 97008-4045 | 2015-03-03 |
| 1609267996 | Orenco Massage Studio LLC | Health Maintenance Organization | 1915 Nw Amberglen Pkwy, Suite #400, Beaverton, OR 97006-6951 | 2015-02-09 |
| 1194143065 | Willamette Dental | Health Maintenance Organization | 4925 Sw Griffith Dr, Beaverton, OR 97005-2923 | 2014-03-28 |
| 1225465875 | Maranda Gaspar | Health Maintenance Organization | 3720 Sw 141st Ave, Suite 100, Beaverton, OR 97005-2382 | 2013-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073061859 | Logan Calahan | Health Maintenance Organization | 5028 Cumberland Ct Se, Salem, OR 97306-2011 | 2016-09-21 |
| 1306394796 | Rejuven8 Massage and Float Therapy, LLC | Health Maintenance Organization | 249 Liberty St Ne # B60, Salem, OR 97301-3503 | 2016-09-14 |
| 1043767445 | Kaiser Permanente | Health Maintenance Organization | 5381 W Baseline Rd, Hillsboro, OR 97123-6447 | 2016-09-02 |
| 1346607751 | Atrio Health Plans, Inc. | Health Maintenance Organization | 2270 Nw Aviation Dr Ste 3, Roseburg, OR 97470-2077 | 2016-01-15 |
| 1447624663 | Western Psychological and Counseling Services PC | Health Maintenance Organization | 22070 Ne Chinook Way, Fairview, OR 97024-2647 | 2015-11-26 |
| 1548645872 | Benjamin Murphy Lmt | Health Maintenance Organization | 2516 Ne Clackamas St, Portland, OR 97232-1727 | 2015-07-28 |
| 1467835520 | En8 Pain Management | Health Maintenance Organization | 1803 Lansing Ave Ne, Salem, OR 97301-8733 | 2015-07-07 |
| 1609268556 | Kaiser Permanente | Health Maintenance Organization | 19748 S Sprague Rd, Oregon City, OR 97045-9640 | 2015-03-02 |
| 1982012662 | Muscle and Movement Therapy | Health Maintenance Organization | 5940 Se 138th Pl, Portland, OR 97236-4402 | 2014-07-26 |
| 1093121709 | Rejuven8 Massage, LLC | Health Maintenance Organization | 388 State St. Ne # B60, Salem, OR 97301-3866 | 2014-07-02 |
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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.