NPIMap

Organization Active NPI

Deca Dentistry

  • General Practice Dentistry
  • Gresham, OR
National Provider Identifier
1124548235
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D10377 Issued in OR
Legal business name
DECA DENTISTRY
Practice address
501 NE Hood Ave Ste 235
Gresham, OR 97030-7346
Phone
(503) 661-4900
NPI assigned
Jun 21, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Dr. Beatrice Deca, DMDNPI 1417186990
Title
Dentist/ Owner
Phone
(503) 267-9400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X D10376 OR
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X D10377 OR Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X

Addresses

Primary practice location

501 NE Hood Ave Ste 235
Gresham, OR 97030-7346

Mailing address

501 NE Hood Ave Ste 235
Gresham, OR 97030
Phone (503) 661-4900

Other practice location 1

5440 SW Westgate Dr Ste 165
Portland, OR 97221-2421
Phone (503) 267-9400

National Provider Directory

National Provider Directory

Locations

501 NE Hood Ave
Ste 235
Gresham, OR 97030
Phone (503) 661-4900

5440 SW Westgate Dr
Ste 165
Portland, OR 97221
Phone (503) 267-9400

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1124548235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 NE HOOD AVE STE 235",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "97030",
            "telephone_number": "503-661-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 NE HOOD AVE STE 235",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307346",
            "telephone_number": "503-661-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5440 SW Westgate Dr Ste 165",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972212421",
            "country_code": "US",
            "telephone_number": "503-267-9400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DECA DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-21",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "DECA",
        "authorized_official_first_name": "BEATRICE",
        "authorized_official_title_or_position": "DENTIST/ OWNER",
        "authorized_official_telephone_number": "503-267-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "OR",
            "license": "D10376",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10377",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.