Individual provider Active NPI

Richard Whipple, D.D.S.

  • General Practice Dentistry
  • Tigard, OR
National Provider Identifier
1073556791
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6023 Issued in OR
Practice address
11525 SW Durham Rd
Tigard, OR 97224-3475
Phone
(503) 620-6133
Fax
(503) 620-1275
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6023 OR Primary

Addresses

Primary practice location

11525 SW Durham Rd
Tigard, OR 97224-3475

Mailing address

11525 SW Durham Rd.
D-1
Tigard, OR 97224
Phone (503) 620-6133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190830002247 OR Order and Referring Only - DentistPractitioner - Dentist 4183953086

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6023ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Richard a. Whipple D.D.S General Practice Past Accepting new patients
Kerri Smith, DMD, LLC General Practice PastSince Jun 18, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1073556791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11525 SW DURHAM RD.",
            "address_2": "D-1",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97224",
            "telephone_number": "503-620-6133",
            "fax_number": "503-620-1275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11525 SW DURHAM RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972243475",
            "telephone_number": "503-620-6133",
            "fax_number": "503-620-1275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHIPPLE",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "6023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.