Active NPI
Thomas David Cardwell, DMD
- Dentist
- Portland, OR
National Provider Identifier
1033464524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D10586
- Practice address
- 17130 SW Upper Boones Ferry Rd
Portland, OR 97224-7004 - Phone
- (855) 433-6825
- NPI assigned
- Jul 20, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D10586 | OR | Primary |
Addresses
Primary practice location
17130 SW Upper Boones Ferry Rd
Portland, OR 97224-7004
Mailing address
6950 NE Campus Way
Hillsboro, OR 97124-5611
Phone (503) 913-6193
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170427002518 | OR | Order and Referring Only - Dentist | 0143507202 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D10586 | OR | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491436800000",
"number": "1033464524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6950 NE CAMPUS WAY",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971245611",
"telephone_number": "503-913-6193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17130 SW UPPER BOONES FERRY RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972247004",
"telephone_number": "855-433-6825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARDWELL",
"first_name": "THOMAS",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-20",
"last_updated": "2017-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D10586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
- David Cardus
- Beth Alison Cardwell, MD
- Danielle Teresa Cardwell
- Lori Cardwell, MD
- Silas Cardwell III, MD
- Care 24 LLC
- Care 4 You LLC (Home Helpers Home Care Of Beaverton)
- Care Calm Clinic LLC
- Care Center (Cascade Terrace) Inc. (Cascade Terrace Nursing Center)
- Care Center (Glisan) Inc (Glisan Care Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.