Westover Dental Clinic

Primary specialty

DentistTaxonomy code 122300000X

License

D5148 Issued in OR

Legal business name

WESTOVER DENTAL CLINIC

Practice address

419 NW 23Rd Ave
Suite 102
Portland, OR 97210-3470

Phone

(503) 224-2273

Fax

(503) 224-1176

NPI assigned

Apr 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Charles Belusko, D.M.D.

Title

Dentist

Phone

(503) 224-2273

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Kathleene G Adams, DMD

  • Dentist
  • Portland, OR
  • NPI 1063582252
  NPD (past)
• Ravi Busi, D.D.S.

  • General Practice Dentistry
  • Portland, OR
  • NPI 1952327959
  NPD (past)

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124246285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 NW 23RD AVE",
            "address_2": "SUITE 102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103470",
            "telephone_number": "503-224-2273",
            "fax_number": "503-224-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 NW 23RD AVE",
            "address_2": "SUITE 102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103470",
            "telephone_number": "503-224-2273",
            "fax_number": "503-224-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTOVER DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BELUSKO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "503-224-2273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "D5148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Weston Sports Performance Rehabilitation LLC
• Alice S Weston, M.D.
• Ashford Durham Weston, QMHP, LPC
• Matthew Locke Weston, PT
• Ruth L Weston, RN
• Westover Heights Clinic
• Westside Internal Medicine
• Westside Internal Medicine
• Westside Pediatric Clinic PC
• Westside Periodontics & Implantology LLC

• All providers in Portland, OR
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.