EUGENE OWEN KELLEY (NPI# 1588805311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1588805311 |
Entity Type | Individual |
Full Name | EUGENE OWEN KELLEY |
Credential | DMD |
Practice Address |
611 Sw Campus Dr Portland OR 97239-3001 |
Practice Telephone | 5034940292 |
Practice Fax Number | 5034940294 |
Mailing Telephone | 5034940292 |
Mailing Fax Number | 5034940294 |
Enumeration Date | 2009-03-06 |
Last Update Date | 2009-03-06 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
D3452 | OR | Dental Providers |
Street Address |
611 SW CAMPUS DR |
City | PORTLAND |
State | OR |
Zip Code | 97239-3001 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508827478 | Wei-yuhg Yih | Dentist | 611 Sw Campus Dr, Sd-515, Portland, OR 97239-3001 | 2006-03-30 |
1700227345 | Patra Vasiliki Alatsis | Student in an Organized Health Care Education/Training Program | 611 Sw Campus Dr, Portland, OR 97239-3001 | 2013-07-11 |
1740621796 | Brandon Knapp | Student in an Organized Health Care Education/Training Program | 611 Sw Campus Dr, Ohsu Department of Orthodontics, Portland, OR 97239-3001 | 2013-07-07 |
1669811352 | Grace E. Crary | Dentist | 611 Sw Campus Dr, Rm. 805, Portland, OR 97239-3001 | 2013-06-17 |
1760722219 | Jeremy M Miller | Dental Hygienist | 611 Sw Campus Dr, Portland, OR 97239-3001 | 2013-02-20 |
1730365479 | Juliana Branco Dacosta | Dentist | 611 Sw Campus Dr, Portland, OR 97239-3001 | 2008-01-11 |
1881894376 | Lisa S Yarborough | Dentist | 611 Sw Campus Dr, Portland, OR 97239-3001 | 2007-07-23 |
1659436160 | Barry Joseph Taylor | Dentist | 611 Sw Campus Dr, Faculty Dental Practice, Room 19, Portland, OR 97239-3001 | 2006-12-26 |
1346327905 | Theresa E Madden | Dentist | 611 Sw Campus Dr, Room 19, Portland, OR 97239-3001 | 2006-11-01 |
1720166242 | Larry M Doyle | Dentist | 611 Sw Campus Dr, Portland, OR 97239-3001 | 2006-11-01 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
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 |
1881219657 | Desiree Baer | Licensed Vocational Nurse | Sw Us Veterans Hospital Rd, Portland, OR 97239 | 2020-06-08 |
1285266205 | Melissa Irene Wheeler | Registered Nurse | Uhs-8l, 3181 S.w. Sam Jackson Park Road, Portland, OR 97239 | 2020-02-07 |
1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
1801448063 | Alice Huang Huang | Student in an Organized Health Care Education/Training Program | 3710 Sw Veterans Road, Portland, OR 97239 | 2019-07-09 |
1710446273 | Ellen Noreen Kessi | Social Worker | 3710 Sw Us Veterans Rd., Portland, OR 97239 | 2019-03-14 |
1508335704 | Jacqueline Marie Mular | Marriage & Family Therapist | 5550 Sw Macadam Suite 100, Portland, OR 97239 | 2018-11-16 |
1275030926 | Carly Elizabeth Dougher | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239 | 2018-04-10 |
1780188094 | Dennis John Samuel | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239 | 2018-03-21 |
Find all providers in zip 97239 |
Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356662845 | Baber Nazir Khatib | Dentist | 1849 Nw Kearney St Ste 300, Portland, OR 97209-1453 | 2010-06-18 |
1780728998 | Normund Karl Auzins | Dentist | 3549 N Lombard St, Portland, OR 97217-5901 | 2007-02-19 |
1962412312 | Steven Wayne Beadnell | Dentist | 11786 Sw Barnes Rd Ste 110, Portland, OR 97225-5926 | 2006-08-08 |
1639103658 | Columbia Park Oral Surgery PC | Dentist | 3549 N Lombard, Portland, OR 97217-5901 | 2006-07-10 |
1881674042 | Kim K Erickson | Dentist | 511 10th Ave Suite 808, Portland, OR 97205-4661 | 2006-01-21 |
1871571711 | Daniel Joseph Traub | Dentist | 131 Johnson Rd Suite 3, Portland, ME 04102 | 2006-01-01 |
1972588374 | Julie Ann Smith | Dentist | 8931 Se Foster Rd, Portland, OR 97266-4661 | 2005-12-08 |
1952717084 | Maine Coast Oral Surgery | Dentist | 1601 Congress St, Portland, ME 04102-2102 | 2014-07-09 |
1740695527 | Adam Peter Fagin | Dentist | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2014-06-30 |
1073928289 | Nadir Elias | Dentist | 1849 Nw Kearney St Ste 300, Portland, OR 97209-1453 | 2014-06-25 |
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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.