Family Dental Care, Inc

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

FAMILY DENTAL CARE, INC

Practice address

1890 NE 162ND Ave
Portland, OR 97230-5642

Phone

(503) 644-1110

Fax

(503) 641-6431

NPI assigned

Dec 30, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Hadi Nouredine, DMD

Title

Ceo

Phone

(503) 644-1110

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1230595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230595200000",
    "number": "1124264841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 NE 162ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972305642",
            "telephone_number": "503-644-1110",
            "fax_number": "503-641-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 NE 162ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972305642",
            "telephone_number": "503-644-1110",
            "fax_number": "503-641-6431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-30",
        "last_updated": "2008-12-30",
        "status": "A",
        "authorized_official_last_name": "NOUREDINE",
        "authorized_official_first_name": "HADI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-644-1110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHS CONTRACT NUMBER",
            "identifier": "127058",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda M Faller, RPA/RA, RT(R)
• Nicole R Faller
• Sara L. Fallico, MS CADCI
• Tamara Falls
• Fikayo T Falodun, MD
• Family Ground Counseling LLC
• Family Healthpartners, LLC
• Family Medical Group Northeast, P.C.
• Family Practice Clinic LLC
• Family Skillbuilders, Inc.

• Health Maintenance Organization in Portland, OR
• Providers in Portland, OR by specialty
• Health Maintenance Organization in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2008; 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.