NPIMap

Organization Active NPI

Charles L Branen DMD PC

  • Dental Clinic/Center
  • Portland, OR
National Provider Identifier
1053614396
Registry record updated Dec 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D7206 Issued in OR
Legal business name
CHARLES L BRANEN DMD PC
Practice address
4433 NE Tillamook St
Portland, OR 97213-1317
Phone
(503) 288-6963
Fax
(503) 288-4939
NPI assigned
Dec 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2010

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

Authorized official

Name
Dr. Charles Lee Branen, DMD
Title
Dentist
Phone
(503) 288-6963

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D7206 OR Primary

Addresses

Primary practice location

4433 NE Tillamook St
Portland, OR 97213-1317

Mailing address

4433 NE Tillamook St
Portland, OR 97213-1317
Phone (503) 288-6963

National Provider Directory

National Provider Directory
Tax ID family
Charles L Branen DMD PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4433 NE Tillamook St
Portland, OR 97213
Phone (503) 288-6963

NPI Registry JSON

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291766400000",
    "number": "1053614396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4433 NE TILLAMOOK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131317",
            "telephone_number": "503-288-6963",
            "fax_number": "503-288-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4433 NE TILLAMOOK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131317",
            "telephone_number": "503-288-6963",
            "fax_number": "503-288-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES L BRANEN DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-08",
        "last_updated": "2010-12-08",
        "status": "A",
        "authorized_official_last_name": "BRANEN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "503-288-6963",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "D7206",
            "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 Dec 8, 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.