BRUNO DA COSTA DDD,MS,PC (NPI# 1780851105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780851105 |
| Entity Type | Organization |
| Organization Name | BRUNO DA COSTA DDD,MS,PC |
| Other Organization Name | DA COSTA DENTAL |
| Practice Address |
11995 Sw Pacific Hwy Tigard OR 97223-6474 |
| Practice Telephone | 5036396900 |
| Practice Fax Number | 5036848167 |
| Mailing Telephone | 5036396900 |
| Mailing Fax Number | 5036848167 |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2008-05-14 |
| Authorized Official Name | DR. BRUNO CRISTALLI DA COSTA (OWNER/PRESIDENT) |
| Authorized Official Telephone | 5036396900 |
| Authorized Official Credential | DDS, MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D8550 | OR | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | NPI TYPE 1 | 1275532384 | 01 |
| Other Name | Type Code |
|---|---|
| Da Costa Dental | Other Name - Individual/Organization |
| Street Address |
11995 SW PACIFIC HWY |
| City | TIGARD |
| State | OR |
| Zip Code | 97223-6474 |
| 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 | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730661794 | Jesse Thomas Achatz | Dentist | 7275 Sw Dartmouth St Ste 180, Tigard, OR 97223-8292 | 2018-09-05 |
| 1295188027 | Thanh-truc Nguyen | Dentist | 9735 Sw Shady Ln Ste 307, Tigard, OR 97223-5481 | 2016-07-17 |
| 1851772180 | Samuel David Seo | Dentist | 10115 Sw Nimbus Ave Ste 350, Tigard, OR 97223-4330 | 2015-06-11 |
| 1548600695 | Phil Han | Dentist | 11820 Sw King James Place Suite 20, Tigard, OR 97224 | 2013-07-02 |
| 1205135118 | Tigard Family Dental, PC | Dentist | 11820 Sw King James Pl Ste 20, Tigard, OR 97224-2481 | 2011-03-17 |
| 1902136989 | Adam Polan | Dentist | 7275 Sw Dartmouth St, Suite 180, Tigard, OR 97223-8623 | 2010-01-13 |
| 1437486800 | Kelly J Johnson | Dentist | 7420 Sw Bridgeport Rd, Suite 104, Tigard, OR 97224-7790 | 2009-11-05 |
| 1750515888 | Timothy J Houlihan Jr. | Dentist | 15495 Sw Sequoia Pkwy Ste 120, Tigard, OR 97224 | 2009-05-04 |
| 1942465398 | Scott B Bodyfelt | Dentist | 11765 Sw Greenburg Road, Tigard, OR 97223 | 2008-07-25 |
| 1104029446 | Tigard Dental | Dentist | 12720 Sw Pacific Hwy Ste 2, Tigard, OR 97223-6125 | 2007-06-06 |
| Find all providers in TIGARD | ||||
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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.