Active NPI
Timothy Paul Bletscher, D.M.D.
- Dentist
- Portland, OR
National Provider Identifier
1154471555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5666
- Practice address
- 5440 SW Westgate Dr
Suite 215
Portland, OR 97221-2420 - Phone
- (503) 297-3756
- Fax
- (503) 297-0454
- NPI assigned
- Jan 10, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5666 | OR | Primary |
Addresses
Primary practice location
5440 SW Westgate Dr
Suite 215
Portland, OR 97221-2420
Mailing address
5440 SW Westgate Dr
Suite 215
Portland, OR 97221-2420
Phone (503) 297-3756
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5666 | OR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154471555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5440 SW WESTGATE DR",
"address_2": "SUITE 215",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972212420",
"telephone_number": "503-297-3756",
"fax_number": "503-297-0454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5440 SW WESTGATE DR",
"address_2": "SUITE 215",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972212420",
"telephone_number": "503-297-3756",
"fax_number": "503-297-0454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLETSCHER",
"first_name": "TIMOTHY",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "5666",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.