NPIMap

Organization Active NPI

Portland Children'S Dentistry, LLC

  • Dental Clinic/Center
  • Portland, OR
National Provider Identifier
1225458441
Registry record updated Apr 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D9732 Issued in OR
Legal business name
PORTLAND CHILDREN'S DENTISTRY, LLC
Practice address
2323 NW Westover Rd
Portland, OR 97210-3524
Phone
(503) 893-2889
NPI assigned
Apr 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2014

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

Authorized official

Name
Dr. David Jacob Raphael, DDSNPI 1104142900
Title
Co-Owner
Phone
(503) 893-2889

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D9732 OR Primary

Addresses

Primary practice location

2323 NW Westover Rd
Portland, OR 97210-3524

Mailing address

2323 NW Westover Rd
Portland, OR 97210-3524
Phone (503) 893-2889

National Provider Directory

National Provider Directory

Locations

2323 NW Westover Rd
Portland, OR 97210
Phone (503) 893-2889

Practitioners & affiliated clinicians

Practitioners 2

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": "1398556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398556800000",
    "number": "1225458441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 NW WESTOVER RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103524",
            "telephone_number": "503-893-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 NW WESTOVER RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103524",
            "telephone_number": "503-893-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND CHILDREN'S DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-27",
        "last_updated": "2014-04-27",
        "status": "A",
        "authorized_official_last_name": "RAPHAEL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JACOB",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "503-893-2889",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "D9732",
            "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 Apr 27, 2014; 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.