NPIMap

Organization Active NPI

Powell Family Dental

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1023339199
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7590 Issued in OR
Legal business name
POWELL FAMILY DENTAL
Practice address
11050 SE Powell Blvd Ste 378
Portland, OR 97266-1863
Phone
(503) 788-0405
NPI assigned
Jun 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

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

Authorized official

Name
Olga Dontsova, DDS
Title
Dentist
Phone
(503) 788-0405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D7590 OR Primary

Addresses

Primary practice location

11050 SE Powell Blvd Ste 378
Portland, OR 97266-1863

Mailing address

11050 SE Powell Blvd Ste 378
Portland, OR 97266-1863
Phone (503) 788-0405

National Provider Directory

National Provider Directory

Locations

11050 SE Powell Blvd
Ste 378
Portland, OR 97266
Phone (503) 788-0405

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276214400000",
    "number": "1023339199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 SE POWELL BLVD STE 378",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972661863",
            "telephone_number": "503-788-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 SE POWELL BLVD STE 378",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972661863",
            "telephone_number": "503-788-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWELL FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-11",
        "last_updated": "2010-06-11",
        "status": "A",
        "authorized_official_last_name": "DONTSOVA",
        "authorized_official_first_name": "OLGA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "503-788-0405",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.