Thomas Thanh Tieu, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D7324 Issued in OR

Practice address

3620 NE 122ND Ave
Portland, OR 97230-1365

Phone

(503) 254-5575

Fax

(503) 254-2161

NPI assigned

Oct 26, 2006

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

Other identifiers 1

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

Medicare enrollment (NPD)

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.

• Parkrose Family Dentistry, P.C.

  • Dentist
  • Portland, OR
  • NPI 1295811180
  NPD (past) Authorized official

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104901040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 NE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972301365",
            "telephone_number": "503-254-5575",
            "fax_number": "503-254-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 NE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972301365",
            "telephone_number": "503-254-5575",
            "fax_number": "503-254-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEU",
        "first_name": "THOMAS",
        "middle_name": "THANH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON STATE LICENSE",
            "identifier": "D7324",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhonda C Tierney, M.D.
• Chelsea R Tieszen, MD, MS
• Bao-Chau Tieu
• Brandon H Tieu, MD
• Tam Tieu, PA-C
• Tiffany Goldwyn DMD PC
• Tiffany Kettermann, LLC
• Brandi Tiffany, LMT
• Tiffany'S Apotheke, LLC
• Tigard Physical Therapy Inc

• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.