Oral Health Outreach, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D7025 Issued in OR

Legal business name

ORAL HEALTH OUTREACH, LLC

Practice address

4949 Meadows Rd
Suite 475
Lake Oswego, OR 97035-4285

Phone

(503) 702-1113

Fax

(503) 697-1990

NPI assigned

Nov 10, 2011

Last updated

Nov 10, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joseph Francis Markunas

Title

Ceo

Phone

(503) 702-1113

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320883200000",
    "number": "1194002725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 MEADOWS RD",
            "address_2": "SUITE 475",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354285",
            "telephone_number": "503-702-1113",
            "fax_number": "503-697-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 MEADOWS RD",
            "address_2": "SUITE 475",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354285",
            "telephone_number": "503-702-1113",
            "fax_number": "503-697-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL HEALTH OUTREACH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-10",
        "last_updated": "2011-11-10",
        "status": "A",
        "authorized_official_last_name": "MARKUNAS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-702-1113"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "D7025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.