DR. STEVEN RAYMOND DIERICKX (NPI# 1629032255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629032255 |
| Entity Type | Individual |
| Full Name | DR. STEVEN RAYMOND DIERICKX |
| Credential | DMD |
| Practice Address |
2031 Hawthorne St Suite G Forest Grove OR 97116-1700 |
| Practice Telephone | 5033572171 |
| Practice Fax Number | 5033572172 |
| Mailing Telephone | 5033572171 |
| Mailing Fax Number | 5033572172 |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
4924 | OR | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | LICENSE NUMBER | 4924 | 01 |
| Street Address |
2031 HAWTHORNE ST SUITE G |
| City | FOREST GROVE |
| State | OR |
| Zip Code | 97116-1700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649283235 | Jared Michael Thompson | Dentist | 2031 Hawthorne St, Ste A, Forest Grove, OR 97116-1700 | 2006-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780220988 | Jenny Park | Social Worker | 2023 Hawthorne Street, Building C, Forest Grove, OR 97116 | 2019-11-22 |
| 1447742077 | Kimberly K Sabin | Doula | 1239 Goff Rd, Forest Grove, OR 97116 | 2018-05-30 |
| 1891205266 | Sonam Narayan | Optometrist | 2221 Pacific Avenue, Forest Grove, OR 97116 | 2017-10-11 |
| 1013260181 | Sharon Louise Benjamin | Nurse Practitioner | 2724 Harvest Ct, Forest Grove, OR 97116 | 2012-10-25 |
| 1336445535 | Shane Michael Peterson | Physical Therapist | 3300 19th Avenue, Forest Grove, OR 97116 | 2011-02-04 |
| 1023324415 | Kara Marie Cooper | Registered Nurse | 2221 Oak St, Forest Grove, OR 97116 | 2010-08-24 |
| 1811229792 | Rachel Lucinda Erin Dilly | Speech-Language Pathologist | 3300 19th Ave., Forest Grove, OR 97116 | 2010-02-03 |
| 1720286339 | Thuymai Anna Fee | Physical Therapist | Custom Care Physical Therapy, 4150 Pacific Ave. #100, Forest Grove, OR 97116 | 2007-07-05 |
| 1629102454 | Lois Elizabeth Yevdalcia Dimick | Massage Therapist | 2004 Main St, Suite 204, Forest Grove, OR 97116 | 2007-03-15 |
| 1023159936 | Ninette Kay Foster | Contractor | 2329 Pacific Ave., Forest Grove, OR 97116 | 2007-02-12 |
| Find all providers in zip 97116 | ||||
| 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 |
|---|---|---|---|---|
| 1396014338 | Jared M. Thompson, Dmd, LLC | Dentist | 2031 Hawthorne St Ste A, Forest Grove, OR 97116-1700 | 2011-12-20 |
| 1619184843 | Gregory Melvin Johnson | Dentist | 2031 Hawthorne Street, Suite D, Forest Grove, OR 97116-8502 | 2007-05-17 |
| 1992924468 | John Edward Forsyth Jr. | Dentist | 2742 19th Ave., Forest Grove, OR 97116-0655 | 2007-04-24 |
| 1477614634 | Paul James Minor | Dentist | 2320 Pacific Ave, Forest Grove, OR 97116-2450 | 2006-12-12 |
| 1376617845 | Donald A. Compton | Dentist | 2016 Main St, Forest Grove, OR 97116-2335 | 2006-11-17 |
| 1083796296 | Gregory Alan Nemchick | Dentist | 1905 Mountain View Ln, #250, Forest Grove, OR 97116 | 2006-10-19 |
| 1326140872 | Geoffrey Kirk Faris | Dentist | 2031 Hawthorne St Ste B, Forest Grove, OR 97116-1700 | 2006-09-05 |
| 1083600753 | Vaughn G Tidwell | Dentist | 2236 Pacific Ave, Forest Grove, OR 97116-2448 | 2005-09-27 |
| 1841284734 | Eric Lee Burbano | Dentist | 1818 Pacific Ave, Forest Grove, OR 97116-2324 | 2005-09-07 |
| 1790780815 | Thomas F. Alexander | Dentist | 1907 Mountain View Ln, Ste 100, Forest Grove, OR 97116-2274 | 2005-06-15 |
| Find all providers in FOREST GROVE | ||||
| City | FOREST GROVE |
| Zip Code | 97116 |
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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.