Individual provider Active NPI

Nicholas G Dose, D.M.D.

  • General Practice Dentistry
  • Lake Oswego, OR
National Provider Identifier
1013264308
Registry record updated Nov 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D9746 Issued in OR
Practice address
601 1St St Ste a
Lake Oswego, OR 97034-2370
Phone
(503) 636-2525
Fax
(503) 697-5999
NPI assigned
Aug 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D9746 OR Primary

Addresses

Primary practice location

601 1St St Ste a
Lake Oswego, OR 97034-2370

Mailing address

601 1St St Ste a
Lake Oswego, OR 97034-2370
Phone (503) 636-2525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160106001803 OR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3375845464

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D9746ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Nicholas G. Dose, DMD, PC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384214400000",
    "number": "1013264308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 1ST ST STE A",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970342370",
            "telephone_number": "503-636-2525",
            "fax_number": "503-697-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 1ST ST STE A",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970342370",
            "telephone_number": "503-636-2525",
            "fax_number": "503-697-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOSE",
        "first_name": "NICHOLAS",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-06",
        "last_updated": "2013-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.