B and T LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D8162 Issued in OR

Legal business name

B AND T LLC

Practice address

10211 SW Park Way
Portland, OR 97225-5009

Phone

(503) 233-3622

NPI assigned

Sep 25, 2017

Organization subpart

No

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

Authorized official

Name

Bao V Pham, DMD

Title

Owner

Phone

(503) 233-3622

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Laurelhurst Dentistry Doing business as

Locations

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

{
    "created_epoch": "1506297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506297600000",
    "number": "1063921823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10211 SW PARK WAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10211 SW PARK WAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255009",
            "telephone_number": "503-233-3622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B AND T LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-25",
        "last_updated": "2017-09-25",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "BAO",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-233-3622",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR DENTIST",
            "identifier": "1780706226",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laurelhurst Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ana Azizkhani, LAC
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• Moses Azubuike, M.D
• Khefri Azure
• Dalia Baadarani, M.S
• Kalina Mishel Baasten, PHARMD
• Michele Lynn Babaie
• Babak Govan PHD LLC
• Richard Babal, MANAGER

• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2017; 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.