Ryan Douglas McCormick, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D11127 Issued in OR

Practice address

3620 SE Powell Blvd Ste 200
Portland, OR 97202-1880

Phone

(503) 878-8702

Fax

(503) 878-8702

NPI assigned

Sep 6, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cascade View Dentistry, LLC

  dba Cascade View General and Family Dentistry

  • General Practice Dentistry
  • Prineville, OR
  • NPI 1205416864
  NPD Authorized official
• Cascade View Dentistry, LLC

  • General Practice Dentistry
  • Prineville, OR
  • NPI 1437011269
  NPD Authorized official
• Roots Dental Stark LLC

  dba Roots Dental

  • Dental Clinic/Center
  • Portland, OR
  • NPI 1063993749
  NPD (past)

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

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1073162699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 SE POWELL BLVD STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021880",
            "telephone_number": "503-878-8702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 SE POWELL BLVD STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021880",
            "telephone_number": "503-878-8702",
            "fax_number": "503-878-8702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16338 SE Stark St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972333958",
            "country_code": "US",
            "telephone_number": "503-912-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "RYAN",
        "middle_name": "DOUGLAS",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Portland",
            "affiliation": "N",
            "address_1": "3620 SE Powell Blvd Ste 200",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972021880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Portland",
            "affiliation": "N",
            "address_1": "16338 SE Stark St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972333958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jamie Danielle McCormick
• Kelly McCormick, BC-HIS
• Maryann McCormick, DMD
• Megan Patricia McCormick, ND
• Rose Willow McCormick, COUNSELOR ASSOCIATE
• Sarah McCormick, RD
• Sarah McCormick, B.S
• Thomas McCormick
• Casie McCoskey
• Francine Fonkou McCown

• Dentist in Portland, OR
• Providers in Portland, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; 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.