Active NPI
John H Frick DMD PC, DMD
- Pediatric Dentistry
- Gresham, OR
National Provider Identifier
1215926720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 4622 P
- Practice address
- 2150 NE Division St
#201
Gresham, OR 97030-5813 - Phone
- (503) 666-9436
- Fax
- (503) 492-4387
- NPI assigned
- Oct 18, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 4622 P | OR | Primary |
Addresses
Primary practice location
2150 NE Division St
#201
Gresham, OR 97030-5813
Mailing address
2150 NE Division St
#201
Gresham, OR 97030-5813
Phone (503) 666-9436
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 |
|---|---|---|---|
| 4622 P | OR | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jiyoung E Lee DMD PC | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Dentistry
- Gresham, OR
- NPI 1942573118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1215926720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2150 NE DIVISION ST",
"address_2": "#201",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970305813",
"telephone_number": "503-666-9436",
"fax_number": "503-492-4387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2150 NE DIVISION ST",
"address_2": "#201",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970305813",
"telephone_number": "503-666-9436",
"fax_number": "503-492-4387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRICK DMD PC",
"first_name": "JOHN",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-18",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OR",
"license": "4622 P",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.