COLUMBIA PARK ORAL SURGERY PC (NPI# 1639103658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1639103658 |
Entity Type | Organization |
Organization Name | COLUMBIA PARK ORAL SURGERY PC |
Practice Address |
3549 N Lombard Portland OR 97217-5901 |
Practice Telephone | 5032899621 |
Practice Fax Number | 5032892930 |
Mailing Telephone | 5032899621 |
Mailing Fax Number | 5032892930 |
Enumeration Date | 2006-07-10 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MR. JAN A KOONING (PRESIDENT) |
Authorized Official Telephone | 5032899621 |
Authorized Official Credential | DMD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
D6081 | OR | Dental Providers |
Street Address |
3549 N LOMBARD |
City | PORTLAND |
State | OR |
Zip Code | 97217-5901 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770599144 | Jan Andrew Kooning | Dentist | 3549 N Lombard, Portland, OR 97217-5901 | 2006-07-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326531666 | Working Class Medicine LLC | Clinic/Center | 2133 N. Willis Blvd, Studio D, Portland, OR 97217 | 2018-06-12 |
1235643602 | Autism Outreach of Oregon | Occupational Therapist | 10350 N Vancouver Way #1043, Portland, OR 97217 | 2017-11-21 |
1689183717 | Kai-uwe H. Hahn Dmd Dba Edelweiss Dental | Clinic/Center | 3503 N Lombard Street, Portland, OR 97217 | 2017-09-20 |
1407308125 | Occupational Health Centers of The Southwest, P.a. (tx) | Clinic/Center | 3449 N Anchor Street, Ste 300a, Portland, OR 97217 | 2016-10-28 |
1750740577 | Sheila Amoo | Adult Companion | 236 N Killingworth St. Apt.b104, Portland, OR 97217 | 2016-02-22 |
1801282199 | Justine Osborn | Specialist | 4310 N. Interstate Ave, Portland, OR 97217 | 2015-04-13 |
1578957742 | Paul Buck Md, Dds, PC | Clinic/Center | 3332 N Lombard St, Suite C, Portland, OR 97217 | 2015-03-25 |
1295158186 | Rebecca Bulleri | Massage Therapist | 5416 N. Maryland Ave, Portland, OR 97217 | 2014-01-28 |
1659793107 | Shellmire Unlimited, P.C. | Community/Behavioral Health | 4134 N Vancouver Avenue, Suite 102, Portland, OR 97217 | 2014-01-16 |
1417207994 | Sportland Acupuncture LLC | Acupuncturist | 1025 N Humboldt, Portland, OR 97217 | 2012-09-12 |
Find all providers in zip 97217 |
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 |
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 |
1821352238 | Caitlin Barstow Low Magraw | Dentist | 1849 Nw Kearney St Ste 300, Portland, OR 97209-1453 | 2012-06-29 |
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.