Sunnyside Dentistry for Children, P.C.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D6490 Issued in OR

Legal business name

SUNNYSIDE DENTISTRY FOR CHILDREN, P.C.

Practice address

11411 SE Sunnyside Rd
Suite 101
Clackamas, OR 97015-5745

Phone

(503) 855-5100

Fax

(503) 826-5196

NPI assigned

Dec 29, 2009

Organization subpart

No

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

Authorized official

Name

Dr. David E Doyle, Jr, DDS

Title

President

Phone

(503) 855-5100

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dustin Michael Davis, D.D.S.

  • Pediatric Dentistry
  • Clackamas, OR
  • NPI 1063787497
  NPD (past)

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446595200000",
    "number": "1104156959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11411 SE SUNNYSIDE RD",
            "address_2": "SUITE 101",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155713",
            "telephone_number": "503-855-5100",
            "fax_number": "503-826-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11411 SE SUNNYSIDE RD",
            "address_2": "SUITE 101",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155745",
            "telephone_number": "503-855-5100",
            "fax_number": "503-826-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNYSIDE DENTISTRY FOR CHILDREN, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-29",
        "last_updated": "2015-11-04",
        "status": "A",
        "authorized_official_last_name": "DOYLE, JR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-855-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D6490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005996",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa Brianna Sullivan
• Brett Michael Sullivan, D.M.D., M.D.
• Paul Sundstrom, ED.D.
• Sunny View Optometry LLC
• Sunnybrook - Addiction Medicine
• Sunnyside Family Dentistry LLC
• Sunnyside Hood Residencial Treatment Home LLC
• Mark F Surbaugh, M.D.
• Susan Buhler
• Sandhya Susnjara, D.M.D.

• Pediatric Dentistry in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Pediatric Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; 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.