CHRYSTAL L DAVIS (NPI# 1467955195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467955195 |
| Entity Type | Individual |
| Full Name | CHRYSTAL L DAVIS |
| Credential | DA |
| Practice Address |
12750 Se Stark St Portland OR 97233-1539 |
| Mailing Address |
23434 Se Mccabe Rd Sandy OR 97055-8426 |
| Practice Telephone | 9713473009 |
| Practice Fax Number | 9712563277 |
| Mailing Telephone | 5036681813 |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2019-03-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 126800000X | Dental Assistant | 115363 | OR | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114359437 | Chrystal Nicole Davis | Social Worker | 435 Homer Rd, Minden, LA 71055-2933 | 2013-08-09 |
| 1336468750 | Chrystal Jo Davis | Physical Therapist | 110 N Main St, Greenville, PA 16125-1726 | 2010-05-25 |
| 1073799565 | Chrystal L Davis | Counselor | 1600 Montana Ave, El Paso, TX 79902-5622 | 2008-01-14 |
| Street Address |
12750 SE STARK ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97233-1539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184666414 | Ziad Hazim | Dentist | 12750 Se Stark St, Portland, OR 97233-1539 | 2006-06-12 |
| 1467986729 | Samantha J Metcalf | Dental Hygienist | 12750 Se Stark St, Portland, OR 97233-1539 | 2017-04-13 |
| 1346790284 | Jessica R Stratton | Dental Assistant | 12750 Se Stark St, Building E, Portland, OR 97233-1539 | 2016-10-04 |
| 1174979934 | Native American Rehabilitation Association Northwest, Inc. | Dentist | 12750 Se Stark St, Building E, Portland, OR 97233-1539 | 2016-05-11 |
| 1588930747 | Keith Yurevitz | Dental Hygienist | 12750 Se Stark St, Portland, OR 97233-1539 | 2012-03-31 |
| 1225238587 | Caitlin C Han | Dentist | 12750 Se Stark St, Suite E, Portland, OR 97233 | 2007-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448164 | Moore Therapy Services, LLC | Behavioral Analyst | 2053 Se 181st Ave, Portland, OR 97233 | 2020-08-20 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1427573443 | Sunshine Ahc | In Home Supportive Care | 2217 Se 156th Ave, Portland, OR 97233 | 2017-08-10 |
| 1538609433 | Nathaniel Davis Jr. | Counselor | 8915 Se Center St, Tigard, OR 97233 | 2017-02-27 |
| 1154878627 | Oregon Outreach Inc | Case Management | 1740 South East 139th Avenue, Portland, OR 97233 | 2016-09-01 |
| 1023461019 | Julianne Baltzley | Counselor | 2409 Se 149th Avenue, Portland, OR 97233 | 2016-07-14 |
| 1710332143 | Emma Slater | Counselor | 12360 Se Burnside, Portland, OR 97233 | 2016-05-04 |
| 1245621952 | Gregory Brett Bledsoe | Counselor | 1427 Se 182nd Ave., Portland, OR 97233 | 2015-02-17 |
| 1396149852 | Jacqueline Bension | Counselor | 1705 Se 122nd Ave, Portland, OR 97233 | 2014-10-13 |
| 1700206950 | Olga I Zlatova I | Dental Hygienist | 325 Se 154th Ave, Portland, OR 97233 | 2014-04-25 |
| Find all providers in zip 97233 | ||||
| Taxonomy Code | 126800000X |
| Grouping | Dental Providers |
| Classification | Dental Assistant |
| An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821616970 | Miryam Gallardo | Dental Assistant | 216 Se 162nd Ave Apt 38, Portland, OR 97233-3839 | 2020-07-06 |
| 1366911521 | Falasteen Adel | Dental Assistant | 1346 Ne 134th Ave, Portland, OR 97230-3211 | 2018-11-16 |
| 1730449893 | Tammy Loraine Rongone | Dental Assistant | 822 N.e. 181st. Ave, Portland, OR 97230-6708 | 2012-05-23 |
| 1205101201 | Patrick Stevens Edwards | Dental Assistant | 8728 N Haven Ave, Portland, OR 97203-3426 | 2012-03-09 |
| 1548464258 | Julie Rose Jennings | Dental Assistant | 11732 Se Malden Ct, Portland, OR 97266-8101 | 2007-06-14 |
| 1750594164 | Christine Marie Hassing | Dental Assistant | 10102 Ne Glisan, Portland, OR 97220 | 2007-05-08 |
| 1598835423 | Alona Elizabeth Polecastro | Dental Assistant | 4512 Se Woodstock, Portland, OR 97206 | 2006-11-08 |
| 1285724021 | Rachael Annette Chambers | Dental Assistant | 7201 N Interstate, North Interstate Dental, Portland, OR 97217-5523 | 2006-10-13 |
| 1760584809 | Wanessa Chambers | Dental Assistant | 5319 Ne Killingsworth St, Portland, OR 97218-2400 | 2006-09-01 |
| 1407963127 | Christina A Robledo | Dental Assistant | North Interstate Dental, 7201 N Interstate, Portland, OR 97217-5523 | 2006-08-25 |
| 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.