BRYAN CLEVENGER


Address: 7095 Sw Gonzaga St, Tigard, OR 97223-8309
Phone: 8554336825

BRYAN CLEVENGER (NPI# 1780065128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1780065128
Entity Type Individual
Full Name BRYAN CLEVENGER
Credential DDS
Practice Address 7095 Sw Gonzaga St
Tigard
OR 97223-8309
Mailing Address 6950 Ne Campus Way
Hillsboro
OR 97124-5611
Practice Telephone 8554336825
Mailing Telephone 8554336825
Enumeration Date 2015-06-11
Last Update Date 2020-09-30
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
D11035 OR Dental Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
1625 E Mcandrews Rd Ste A, Medford, OR 97504 5417793781 5417796523
7703 Floyd Curl Dr, San Antonio, TX 782293901 2105677000

Office Location

Street Address 7095 SW GONZAGA ST
City TIGARD
State OR
Zip Code 97223-8309

Providers in the same location

NPI Name Taxonomy Address Enumeration
1871602417 Mahmoud Maghsoudlou Dentist 7095 Sw Gonzaga St, Tigard, OR 97223-8309 2006-08-29
1053818625 Dean Roy Gretzinger Dentist 7095 Sw Gonzaga St, Tigard, OR 97223 2018-04-10
1760935563 Lindsay K Taira Dentist 7095 Sw Gonzaga St, Tigard, OR 97223-8309 2016-07-27
1124411541 Hujatullah Bayat Dentist 7095 Sw Gonzaga St, Tigard, OR 97223-8309 2015-03-09
1174889299 Christian B Kecht Dentist 7095 Sw Gonzaga St, Tigard, OR 97223-8309 2012-04-03
1700015146 Suzan Nguyen Dentist 7095 Sw Gonzaga St, Tigard, OR 97223-8309 2009-07-07
1447371869 Nicholas George Mooberry Dentist 7095 Sw Gonzaga St, Tigard, OR 97223-8309 2007-04-03
1912072067 Jeffery Edwin Reddicks Dentist 7095 Sw Gonzaga St, Tigard, OR 97223-8309 2006-11-22
1821161241 Ronda Louise Trotman Dentist 7095 Sw Gonzaga St, Tigard, OR 97223-8309 2006-11-15

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1760042618 Tess Ivie Manso Counselor 8915 Degrees Center St, Tigard, OR 97223 2019-06-13
1780141804 Amybrunermd LLC Obstetrics & Gynecology 6958 Sw Varns Street, Portland, OR 97223 2019-02-25
1417425034 Patience Marie Rutto Counselor 8915 Sw Center Streret, Tigard, OR 97223 2018-11-13
1871089581 Marina E Menegol Behavioral Analyst Center for Social Dynamics, 9115 Southwest Oleson Rd. Ste. 100, Portland, OR 97223 2018-07-05
1215423165 Katherine Virginia Eichner Psychologist 9860 Sw Hall Blvd Ste B, Tigard, OR 97223 2018-07-03
1043717390 Rayna Donnelly Physician Assistant 9735 Sw Shady Ln Ste 102, Tigard, OR 97223 2018-04-11
1376059725 Kaylie Marilyn Reyes Behavioral Analyst 9115 Sw Oleson Road, Portland, OR 97223 2017-12-21
1841704004 Kathleen Terrell Taylor Occupational Therapist 7320 Sw Hunziker, Suite 203, Tigard, OR 97223 2017-11-27
1487163036 Susie Riess Counselor 10763 Sw Greenburg Road, Suite 100, Tigard, OR 97223 2017-09-27
1043731243 Tam Nguyen Optometrist 8795 Sw Scholls Ferry Rd Ste 100, Tigard, OR 97223 2017-06-28
Find all providers in zip 97223

Taxonomy Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

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

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1235249160 Dennis P. Clark, D.m.d., P.C. Dentist 9430 Sw Coral St, Suite 200, Tigard, OR 97223-6691 2006-08-30
1114121720 Jeffrey M Burstein Dentist 12750 Sw 68th Ave, Tigard, OR 97223-8596 2007-06-14
1679776603 Robert J Wood Dentist 11565 Sw Durham Rd, Suite 100, Tigard, OR 97224-3553 2007-06-07
1386868370 Dennis P Clark Dentist 9430 Sw Coral St, Suite 200, Tigard, OR 97223-6691 2007-04-12
1538281068 Gregory P Delgado Dentist 10115 Sw Nimbus Ave, Suite 350, Tigard, OR 97223-4349 2007-04-04
1912072067 Jeffery Edwin Reddicks Dentist 7095 Sw Gonzaga St, Tigard, OR 97223-8309 2006-11-22
1972564847 Frank J Kratochvil IIi Dentist 12254 Sw Garden Pl, Tigard, OR 97223-8246 2006-03-30

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1831686468 Jev A. Clark, Dmd, Md, LLC Dentist 120 Ramsgate Sq S Ste 110, Salem, OR 97302-5870 2018-04-19
1417385857 Northwest Oral and Maxillofacial Surgeons Dentist 24850 Se Stark St Ste 100, Gresham, OR 97030-8317 2013-10-22
1457699142 Bryan Christopher Williams Dentist 330 S Garden Way Ste 140, Eugene, OR 97401 2013-01-30
1689932063 Garrett Welch Dentist 1475 Sw Chandler Ave Ste 101, Bend, OR 97702 2012-04-24
1164712022 Travis Jon Hamilton Dentist 250 Church St Se Ste 102, Salem, OR 97301-3758 2011-04-12
1770887648 Humble Richmond & Russell Oral & Maxillofacial Surgery, LLC Dentist 911 Main St Ste 180, Oregon City, OR 97045-1870 2011-01-06
1710291265 Auzins Warrenton LLC Dentist 65 N Highway 101 Ste C, Warrenton, OR 97146-9313 2010-07-27
1932411303 Normund Karl Auzins Dds Dentist 1725 Saint Helens St, Saint Helens, OR 97051-1744 2010-07-13
1356662845 Baber Nazir Khatib Dentist 1849 Nw Kearney St Ste 300, Portland, OR 97209-1453 2010-06-18
1700012010 Dylan S Spendal Dentist 5025 Ne Elam Young Pkwy, Suite 100, Hillsboro, OR 97124-6403 2009-06-02
Find all providers with the same taxonomy

Competitor

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City TIGARD
Zip Code 97223

Improve Information

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Dataset Information

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.

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