Perledent Dental Care, PC

Primary specialty

DentistTaxonomy code 122300000X

License

D10365 Issued in OR

Legal business name

PERLEDENT DENTAL CARE, PC

Practice address

16755 SW Baseline Rd
Beaverton, OR 97006-4241

Phone

(503) 533-4001

NPI assigned

Nov 4, 2015

Last updated

Nov 4, 2015By 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

Dr. Kyle H VanNPI 1770570251

Title

Owner Dentist

Phone

(503) 533-4001

Specialties & licenses 1

Addresses

Tax ID family

Perledent Dental Care PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Perledent Dental Care PC

  • Dental Clinic/Center
  • Hillsboro, OR
  • NPI 1841529823
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kyle H. Van, D.D.S.

  • General Practice Dentistry
  • Beaverton, OR
  • NPI 1770570251
  NPD (past) Authorized official

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446595200000",
    "number": "1255704813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16755 SW BASELINE RD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064241",
            "telephone_number": "503-533-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16755 SW BASELINE RD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064241",
            "telephone_number": "503-533-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERLEDENT DENTAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-04",
        "status": "A",
        "authorized_official_last_name": "VAN",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "503-533-4001",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Beth Perez de la Cruz, MSW, LCSW
• Alexis Perez
• Lillian Elizabeth Perez
• Perio Aesthetics & Implantology
• David Edward Perkins, RN
• Christine Bette Perrine
• Elena Victoria Perrine
• Chris Perry, MS, CRC, NCC, LPCI
• Christina Lee Perry, MOT
• Craig Perry, CSWA

• Dentist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; 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.