Active NPI
Christopher R Sierk, D.D.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Tigard, OR
National Provider Identifier
1104001106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- D7192
- Practice address
- 11565 SW Hall Blvd
Tigard, OR 97223-8493 - Phone
- (503) 620-6606
- Fax
- (503) 624-6382
- NPI assigned
- Jan 8, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | D7192 | OR | Primary |
Addresses
Primary practice location
11565 SW Hall Blvd
Tigard, OR 97223-8493
Mailing address
11565 SW Hall Blvd
Tigard, OR 97223-8493
Phone (503) 620-6606
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D7192 | OR | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199750400000",
"number": "1104001106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11565 SW HALL BLVD",
"city": "TIGARD",
"state": "OR",
"postal_code": "972238493",
"telephone_number": "503-620-6606",
"fax_number": "503-624-6382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11565 SW HALL BLVD",
"city": "TIGARD",
"state": "OR",
"postal_code": "972238493",
"telephone_number": "503-620-6606",
"fax_number": "503-624-6382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIERK",
"first_name": "CHRISTOPHER",
"middle_name": "R",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-08",
"last_updated": "2008-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "OR",
"license": "D7192",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.