HERITAGE DENTAL (NPI# 1669759767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669759767 |
| Entity Type | Organization |
| Organization Name | HERITAGE DENTAL |
| Practice Address |
4511 Se Hawthorne Blvd Suite 101 Portland OR 97215-3195 |
| Practice Telephone | 5032318228 |
| Practice Fax Number | 5032315634 |
| Mailing Telephone | 5032318228 |
| Mailing Fax Number | 5032315634 |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2013-07-11 |
| Authorized Official Name | MRS. DENISE JEAN CRANE (OFFICE MANAGER) |
| Authorized Official Telephone | 5032318228 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
9096 | OR | Ambulatory Health Care Facilities |
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
5651 | OR | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255765863 | Heritage Dental | Dentist | 9590 Marbach Rd, San Antonio, TX 78245-1825 | 2013-08-30 |
| 1356490700 | Heritage Dental | Dentist | 800 Main St, Antioch, IL 60002-1542 | 2007-01-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | HERITAGE DENTAL GROUP, PLLC | 3773 Cherry Creek North Dr, Suite 120, Denver, CO 80209 |
| Iowa Business Entities | HERITAGE DENTAL LLC | 1400 10th Ave Sw, P.o. Box 854, Waverly, IA 50677 |
| Massachusetts Corporations | HERITAGE DENTAL MANAGEMENT CORPORATION | 1400 Worcester Road, Natick, MA 01760 |
| Iowa Business Entities | HERITAGE DENTAL PARTNERS, LLC | 1026 Woodbury Ave, Council Bluffs, IA 51503 |
| Iowa Business Entities | HERITAGE DENTAL PROPERTIES, LLC | 516 Nw Country Club Ln, Ankeny, IA 50023 |
| Oregon Corporations, Companies and Business Names | HERITAGE DENTAL, LLC | 4511 Se Hawthorne Blvd Ste 101, Portland, OR 97215 |
| Street Address |
4511 SE HAWTHORNE BLVD SUITE 101 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97215-3195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932104825 | Jonna Elizabeth Hongo | Dentist | 4511 Se Hawthorne Blvd, Ste 110, Portland, OR 97215-3170 | 2005-06-16 |
| 1083154637 | Mindful Awakenings, LLC | Community/Behavioral Health | 4511 Se Hawthorne Blvd, Suite 204, Portland, OR 97215-3182 | 2017-03-01 |
| 1306394663 | Lauren Deisenroth Pmhnp-bc LLC | Clinic/Center | 4511 Se Hawthorne Blvd, Suite 215, Portland, OR 97215-3170 | 2016-09-15 |
| 1689065864 | Elin Katrina Allen | Dental Hygienist | 4511 Se Hawthorne Blvd, Ste 101, Portland, OR 97215-3170 | 2015-02-10 |
| 1881025872 | Travis Jonquil | Massage Therapist | 4511 Se Hawthorne Blvd, Suite 204, Portland, OR 97215-3170 | 2013-12-02 |
| 1336434703 | Dr. Jonna E. Hongo | Clinic/Center | 4511 Se Hawthorne Blvd, Suite 110, Portland, OR 97215-3170 | 2011-06-14 |
| 1770886939 | Karina Marie Jarvela | Naturopath | 4511 Se Hawthorne Blvd, Suite 208, Portland, OR 97215 | 2010-12-09 |
| 1518106319 | Richard Justin Tooke | Dentist | 4511 Se Hawthorne Blvd, Portland, OR 97215-3170 | 2009-02-18 |
| 1174771703 | Charles Leroy Wilk | Acupuncturist | 4511 Se Hawthorne Blvd, Suite 214, Portland, OR 97215-3170 | 2008-09-08 |
| 1114194818 | Hawthorne Dental | Dentist | 4511 Se Hawthorne Blvd, Ste 205, Portland, OR 97215-3170 | 2008-05-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952926339 | Lisa Silverman | Counselor | 1835 Se 50th Avenue, Portland, OR 97215 | 2020-06-11 |
| 1003381195 | Darcie Leigh Juarez | Naturopath | 6118 Se Belmont St Ste 407, Portland, OR 97215 | 2018-10-04 |
| 1740710581 | Riley W Protz | Pharmacist | 5544 E Bursnide, Portland, OR 97215 | 2017-06-14 |
| 1114459088 | Genevieve Kathleen Shields | Registered Nurse | 5451 Se Belmont, Suite 100, Portland, OR 97215 | 2017-03-30 |
| 1205282514 | Aiyana Lucas | Social Worker | 4531 Se Belmont St Ste 310b, Portland, OR 97215 | 2016-05-05 |
| 1508223918 | Catherine Ann Chapman | Counselor | 422 Se 79th Street, Suite 202, Portland, OR 97215 | 2016-01-15 |
| 1518338854 | Cody Begdorian | Acupuncturist | 4220 Se Stark, Portland, OR 97215 | 2015-10-13 |
| 1588040653 | Corinne Leblanc | Acupuncturist | 2305 Se 50th Ave., Suite 200, Portland, OR 97215 | 2015-07-30 |
| 1942688544 | Casey Lynne Peters | Occupational Therapist | 6040 Se Belmont S, Portland, OR 97215 | 2015-05-14 |
| 1457743783 | David Alexander Gambill | Counselor | 8041 E Burnside St., Portland, OR 97215 | 2015-02-24 |
| Find all providers in zip 97215 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003430711 | Md Portland LLC | Clinic/Center | 15 Middle St # A-c2, Portland, ME 04101-4881 | 2020-05-29 |
| 1598396350 | Roots Dental, Pllc | Clinic/Center | 191 Marginal Way Ste C, Portland, ME 04101-3387 | 2020-01-30 |
| 1063065068 | Portland Dental Smiles | Clinic/Center | 732 Sw 3rd Ave Ste 202, Portland, OR 97204-2409 | 2019-07-18 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1063993749 | Roots Dental Stark LLC | Clinic/Center | 16338 Se Stark St, Portland, OR 97233-3958 | 2018-08-22 |
| 1528546330 | Christopher Brady Dmd LLC | Clinic/Center | 4707 Ne 102nd Ave Ste A, Portland, OR 97220-3393 | 2018-08-02 |
| 1124511191 | Enk Dental PC | Clinic/Center | 6516 Ne Siskiyou St, Portland, OR 97213-4572 | 2018-06-13 |
| 1760997654 | Gary S Hongo Dmd, LLC | Clinic/Center | 9732 Se Washington St Ste H, Portland, OR 97216-8405 | 2017-12-13 |
| 1689183717 | Kai-uwe H. Hahn Dmd Dba Edelweiss Dental | Clinic/Center | 3503 N Lombard Street, Portland, OR 97217 | 2017-09-20 |
| 1962930362 | Alaniz Family & Cosmetic Dentistry, PC | Clinic/Center | 11701 Se Stark St, Portland, OR 97216-3759 | 2017-05-30 |
| 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.