Randall N Freed, D.M.D.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

5171 Issued in OR

Legal business name

RANDALL N FREED, D.M.D.

Practice address

12887 NW Cornell Rd
Ste a
Portland, OR 97229-5894

Phone

(503) 646-9687

Fax

(503) 619-0066

NPI assigned

Aug 5, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Randall N Freed, D.M.D.

Title

Owner/Dentist

Phone

(503) 646-9687

Specialties & licenses 1

Addresses

Other names 1

• Cornell Family Dental Other name

Locations

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280966400000",
    "number": "1063726644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12887 NW CORNELL RD",
            "address_2": "STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295894",
            "telephone_number": "503-646-9687",
            "fax_number": "503-619-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12887 NW CORNELL RD",
            "address_2": "STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295894",
            "telephone_number": "503-646-9687",
            "fax_number": "503-619-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALL N FREED, D.M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-05",
        "last_updated": "2010-08-05",
        "status": "A",
        "authorized_official_last_name": "FREED",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "503-646-9687",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": "5171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornell Family Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ran Ran, M.D.
• Corrine Lynai Ranard, LMT
• Gasner Rancy, NP
• Deborah L Rand, RN
• Livian Marie Rand
• Deeann Laura Randall-Zahn, A.B.O.C.
• Amber Kaye Randall
• Andrea Beth-Calhoun Randall
• April Randall
• Caryn Randall, LCSW

• Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.