BRYAN CLEVENGER (NPI# 1780065128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
D11035 | OR | Dental Providers |
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 |
Street Address |
7095 SW GONZAGA ST |
City | TIGARD |
State | OR |
Zip Code | 97223-8309 |
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 |
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 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 |
---|---|---|---|---|
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 |
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 |
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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.