The TMJ Clinic, PC

Primary specialty

DentistTaxonomy code 122300000X

License

D5679 Issued in OR

Legal business name

THE TMJ CLINIC, PC

Practice address

833 SW 11TH Ave
Suite 810
Portland, OR 97205-2125

Phone

(503) 241-7353

Fax

(503) 525-2966

NPI assigned

Apr 3, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Joanne Delmonico

Title

Office Manager

Phone

(503) 241-7353

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1238716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453420800000",
    "number": "1114169216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 SW 11TH AVE",
            "address_2": "SUITE 810",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052125",
            "telephone_number": "503-241-7353",
            "fax_number": "503-525-2966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 SW 11TH AVE",
            "address_2": "SUITE 810",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052125",
            "telephone_number": "503-241-7353",
            "fax_number": "503-525-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE TMJ CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-03",
        "last_updated": "2016-01-22",
        "status": "A",
        "authorized_official_last_name": "DELMONICO",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-241-7353",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "D5679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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