Bridge City Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D7364 Issued in OR

Legal business name

BRIDGE CITY DENTAL, LLC

Practice address

4713 N Lagoon Ave
Portland, OR 97217-7644

Phone

(503) 283-1433

NPI assigned

Dec 17, 2013

Organization subpart

No

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

Authorized official

Name

Jon Robinson, DMD

Title

Owner

Phone

(503) 636-9800

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Hanna Karlin, DMD

  • Dentist
  • Portland, OR
  • NPI 1922176486
  NPD (past)

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387238400000",
    "number": "1154742252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4713 N LAGOON AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972177644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4713 N LAGOON AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972177644",
            "telephone_number": "503-283-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE CITY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-17",
        "last_updated": "2013-12-17",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-636-9800",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Bricker, LMT, MSCN
• Marisa Brickman, MS, OTR/L
• Robert Harlan Bridenbaugh, M.D.
• Bridge City Behavioral Health LLC
• Bridge City Counseling LLC
• Bridge City Electrology and Aesthetics
• Bridge City Family Medical Clinic, PC
• Bridge City Labs, LLC
• Bridge City Medical Transportation LLC
• Bridge of Hope Mental Health Services LLC

• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.