Clarence J Zack-Cade, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12052 Issued in OR

Practice address

7130 SW Canyon Rd
Portland, OR 97225-3225

Phone

(503) 309-5028

NPI assigned

Jul 19, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Clarence J Z Cade Other name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1245078401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7130 SW CANYON RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972253225",
            "telephone_number": "503-309-5028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7130 SW CANYON RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972253225",
            "telephone_number": "503-309-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACK-CADE",
        "first_name": "CLARENCE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D12052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLARENCE",
            "last_name": "CADE",
            "middle_name": "J Z",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Belle Zaccari, PSY.D.
• Andrew Christian Zacest, MBBS
• Diane Zacharias, RD
• Zachary Nelms Lac
• Brian M Zacher, PHARMD
• Esther Leila Zack, M.A.
• Azita Zadeh, PTDA
• Elena Zadniprovskiy
• Mamie Nzigire Zagabe
• Catherine Zagidullina

• 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 Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.