NE 82ND AVENUE DENTAL LLC (NPI# 1700192184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700192184 |
| Entity Type | Organization |
| Organization Name | NE 82ND AVENUE DENTAL LLC |
| Practice Address |
2150 Ne 82nd Ave Portland OR 97220-5607 |
| Practice Telephone | 5032540897 |
| Practice Fax Number | 5032540894 |
| Mailing Telephone | 5032540897 |
| Mailing Fax Number | 5032540894 |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2010-08-24 |
| Authorized Official Name | SARAH NICHOL (OFFICE MANAGER) |
| Authorized Official Telephone | 5032540897 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
D9389 | OR | Ambulatory Health Care Facilities |
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
D8961 | OR | Ambulatory Health Care Facilities |
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D8506 | OR | Ambulatory Health Care Facilities |
| Street Address |
2150 NE 82ND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97220-5607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740309558 | Lilia Herrera | Dentist | 2150 Ne 82nd Ave, Portland, OR 97220-5607 | 2007-03-29 |
| 1235783853 | Joseph Jamus | Dentist | 2150 Ne 82nd Ave, Portland, OR 97220-5607 | 2019-07-31 |
| 1730556309 | Jennifer Sigel | Dental Hygienist | 2150 Ne 82nd Ave, Portland, OR 97220-5607 | 2015-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
| 1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
| 1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
| 1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
| 1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
| Find all providers in zip 97220 | ||||
| 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.