Exceptional Needs Dental Services (Ends)

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

821498 Issued in OR

Legal business name

EXCEPTIONAL NEEDS DENTAL SERVICES (ENDS)

Practice address

12029 NE Sumner St
Portland, OR 97220-9015

Phone

(503) 295-1201

Fax

(503) 295-1211

NPI assigned

Dec 19, 2006

Organization subpart

No

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

Authorized official

Name

Tonia Ayres

Title

Administrator

Phone

(503) 295-1201

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361491200000",
    "number": "1073676037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12029 NE SUMNER ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972209015",
            "telephone_number": "503-295-1201",
            "fax_number": "503-295-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12029 NE SUMNER ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972209015",
            "telephone_number": "503-295-1201",
            "fax_number": "503-295-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEPTIONAL NEEDS DENTAL SERVICES (ENDS)",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2013-02-22",
        "status": "A",
        "authorized_official_last_name": "AYRES",
        "authorized_official_first_name": "TONIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "503-295-1201"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "OR",
            "license": "821498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "086020",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Portland, OR
• Providers in Portland, OR by specialty
• Health Maintenance Organization in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; 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.