FOREST GROVE KIDS' DENTIST, LLC (NPI# 1932524956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932524956 |
| Entity Type | Organization |
| Organization Name | FOREST GROVE KIDS' DENTIST, LLC |
| Practice Address |
2742 19th Ave Forest Grove OR 97116-2623 |
| Practice Telephone | 3608520809 |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2014-02-27 |
| Authorized Official Name | TIMOTHY RICHARDSON (OWNER) |
| Authorized Official Telephone | 3608520809 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | Y |
| Parent Organization Name | TRR, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D9577 | OR | Ambulatory Health Care Facilities |
| Street Address |
2742 19TH AVE |
| City | FOREST GROVE |
| State | OR |
| Zip Code | 97116-2623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780220988 | Jenny Park | Social Worker | 2023 Hawthorne Street, Building C, Forest Grove, OR 97116 | 2019-11-22 |
| 1447742077 | Kimberly K Sabin | Doula | 1239 Goff Rd, Forest Grove, OR 97116 | 2018-05-30 |
| 1891205266 | Sonam Narayan | Optometrist | 2221 Pacific Avenue, Forest Grove, OR 97116 | 2017-10-11 |
| 1013260181 | Sharon Louise Benjamin | Nurse Practitioner | 2724 Harvest Ct, Forest Grove, OR 97116 | 2012-10-25 |
| 1336445535 | Shane Michael Peterson | Physical Therapist | 3300 19th Avenue, Forest Grove, OR 97116 | 2011-02-04 |
| 1023324415 | Kara Marie Cooper | Registered Nurse | 2221 Oak St, Forest Grove, OR 97116 | 2010-08-24 |
| 1811229792 | Rachel Lucinda Erin Dilly | Speech-Language Pathologist | 3300 19th Ave., Forest Grove, OR 97116 | 2010-02-03 |
| 1720286339 | Thuymai Anna Fee | Physical Therapist | Custom Care Physical Therapy, 4150 Pacific Ave. #100, Forest Grove, OR 97116 | 2007-07-05 |
| 1629102454 | Lois Elizabeth Yevdalcia Dimick | Massage Therapist | 2004 Main St, Suite 204, Forest Grove, OR 97116 | 2007-03-15 |
| 1023159936 | Ninette Kay Foster | Contractor | 2329 Pacific Ave., Forest Grove, OR 97116 | 2007-02-12 |
| Find all providers in zip 97116 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144834375 | Geoffrey R Clive Dds LLC | Clinic/Center | 11082 Se Oak St, Milwaukie, OR 97222-6692 | 2020-09-04 |
| 1508416041 | Columbia River Dentistry-gresham, LLC | Clinic/Center | 1700 Nw Civic Dr Ste 320, Gresham, OR 97030-3774 | 2019-09-17 |
| 1063065068 | Portland Dental Smiles | Clinic/Center | 732 Sw 3rd Ave Ste 202, Portland, OR 97204-2409 | 2019-07-18 |
| 1104478619 | David A Allen Dds | Clinic/Center | 1059 Royal Ave, Medford, OR 97504-6127 | 2019-07-15 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1164080875 | Central Point Dental LLC | Clinic/Center | 12338 Se 143rd Pl, Happy Valley, OR 97086-6545 | 2019-05-29 |
| 1285193003 | Hazelnut Dental LLC | Clinic/Center | 10773 Sw Beaverton-hillsdale Hwy, Ste B, Beaverton, OR 97005 | 2019-03-19 |
| 1558839498 | Kevin Prates Dds, PC | Clinic/Center | 1002 10th St Ste 1, Hood River, OR 97031-1564 | 2018-11-08 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | FOREST GROVE |
| Zip Code | 97116 |
Please comment or provide details below to improve the information on FOREST GROVE KIDS' DENTIST, LLC.
| 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.