Northwest Dental Associates, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9255 Issued in OR

Legal business name

NORTHWEST DENTAL ASSOCIATES, PC

Practice address

4655 SW Griffith Dr
Suite 105
Beaverton, OR 97005-8711

Phone

(503) 644-1400

Fax

(503) 646-1913

NPI assigned

Oct 27, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Aracelly Montenegro

Title

Senior Manager

Phone

(714) 578-6358

Specialties & licenses 1

Addresses

Other names 1

• Bright Now Dental Doing business as

Locations

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459468800000",
    "number": "1104902667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SANDPOINTE AVE",
            "address_2": "8TH FLOOR",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927075778",
            "telephone_number": "714-428-1300",
            "fax_number": "714-428-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 SW GRIFFITH DR",
            "address_2": "SUITE 105",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970058711",
            "telephone_number": "503-644-1400",
            "fax_number": "503-646-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST DENTAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2016-04-01",
        "status": "A",
        "authorized_official_last_name": "MONTENEGRO",
        "authorized_official_first_name": "ARACELLY",
        "authorized_official_title_or_position": "SENIOR MANAGER",
        "authorized_official_telephone_number": "714-578-6358",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bright Now Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Beaverton, OR
• Providers in Beaverton, 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 Apr 1, 2016; 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.