Peter Douglas DDS LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PETER DOUGLAS DDS LLC

Doing business as

Tigard Pediatric Dentistry

Practice address

12011 SW 70TH Ave
Tigard, OR 97223-9634

Phone

(503) 616-2024

Fax

(503) 616-2328

NPI assigned

Oct 24, 2024

Last updated

Oct 24, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Peter Douglas, DDSNPI 1861999864

Title

Owner

Phone

(712) 560-6260

Specialties & licenses 1

Addresses

Other names 1

• Tigard Pediatric Dentistry Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peter Douglas, DDS

  • Pediatric Dentistry
  • Portland, OR
  • NPI 1861999864
  NPD Authorized official

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

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1063234722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12011 SW 70TH AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972239634",
            "telephone_number": "503-616-2024",
            "fax_number": "503-616-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12011 SW 70TH AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972239634",
            "telephone_number": "503-616-2024",
            "fax_number": "503-616-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER DOUGLAS DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-560-6260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tigard Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Permanente Dental Associates, PC
• Hope Perrapato
• Jaclyn Rae Perry
• Kayla Perry, THW
• Steven Dean Perry
• Tabitha Kristine Peters
• Amber Petersen
• Catherine Ann Petersen, LMT
• Daniele Paige Peterson, B.S.
• Hannah Marie Peterson

• Dental Clinic/Center in Tigard, OR
• Providers in Tigard, OR by specialty
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.