East Portland Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

380578 Issued in OR

Legal business name

EAST PORTLAND DENTISTRY

Practice address

9 NE 120TH Ave
Portland, OR 97220-2348

Phone

(503) 255-2424

Fax

(503) 253-0150

NPI assigned

May 7, 2007

Organization subpart

No

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

Authorized official

Name

Cindy M Keller

Title

Office Coordinator

Phone

(503) 255-2424

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453939200000",
    "number": "1255544417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 NE 120TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972202348",
            "telephone_number": "503-255-2424",
            "fax_number": "503-253-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 NE 120TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972202348",
            "telephone_number": "503-255-2424",
            "fax_number": "503-253-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST PORTLAND DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2016-01-28",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE COORDINATOR",
        "authorized_official_telephone_number": "503-255-2424"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "380578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DURABLE MEDICAL EQUIPMENT & MEDICAL SUPPLIES",
            "identifier": "1851458533",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Easley
• Donna Easlick
• East by Northwest Integrative Medicine
• East City Dental
• East Meets West Acupuncture and Massage, LLC
• East Portland Medical Associates LLC
• East Portland Neurology Clinic PC
• East Portland Optical Service
• East Portland Pediatric Clinic, P.C.
• East Portland Peritoneal Dialysis Clinic, LLC (U.S. Renal Care East Portland Home Dialysis)

• 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 Jan 28, 2016; 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.