NPIMap

Organization Active NPI

Providence Health & Services-Oregon

Doing business as Providence Child Center

  • Dental Clinic/Center
  • Portland, OR
National Provider Identifier
1124343215
Registry record updated Mar 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PROVIDENCE HEALTH & SERVICES-OREGON
Doing business as
Providence Child Center
Practice address
830 NE 47TH Ave
Attn: Dental Clinic
Portland, OR 97213-2212
Phone
(503) 215-2400
Fax
(503) 215-0660
NPI assigned
Mar 31, 2010
Last updated
Mar 31, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2010

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

Authorized official

Name
Patricia Jean Budo, LCSW, NHA, JD
Title
Operations Administrator
Phone
(503) 215-2413

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

830 NE 47TH Ave
Attn: Dental Clinic
Portland, OR 97213-2212

Mailing address

830 NE 47TH Ave
Attn: Finance
Portland, OR 97213-2212
Phone (503) 215-2400

Other names 1

  • Providence Child Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Providence Child Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1269993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269993600000",
    "number": "1124343215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 NE 47TH AVE",
            "address_2": "ATTN: FINANCE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132212",
            "telephone_number": "503-215-2400",
            "fax_number": "503-215-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 NE 47TH AVE",
            "address_2": "ATTN: DENTAL CLINIC",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132212",
            "telephone_number": "503-215-2400",
            "fax_number": "503-215-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES-OREGON",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-31",
        "last_updated": "2010-03-31",
        "status": "A",
        "authorized_official_last_name": "BUDO",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OPERATIONS ADMINISTRATOR",
        "authorized_official_telephone_number": "503-215-2413",
        "authorized_official_credential": "LCSW, NHA, JD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Child Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2010; 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.