Tualatin Pediatric Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D9222 Issued in OR

Legal business name

TUALATIN PEDIATRIC DENTISTRY

Practice address

18803 SW Boones Ferry Rd
Suite 5
Tualatin, OR 97062-8412

Phone

(503) 692-3747

Fax

(503) 612-6948

NPI assigned

Dec 12, 2013

Last updated

Dec 12, 2013By 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. Lisa S Yarborough, DDS

Title

Pediatric Dentist

Phone

(503) 692-3747

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Lisa S Kispert, DDS

  • Pediatric Dentistry
  • Tualatin, OR
  • NPI 1881894376
  NPD (past)
• Patricia L Ridgley, D.M.D

  • Pediatric Dentistry
  • Tualatin, OR
  • NPI 1265430821
  NPD (past)

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386806400000",
    "number": "1255762449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18803 SW BOONES FERRY RD",
            "address_2": "SUITE 5",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628412",
            "telephone_number": "503-692-3747",
            "fax_number": "503-612-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18803 SW BOONES FERRY RD",
            "address_2": "SUITE 5",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628412",
            "telephone_number": "503-692-3747",
            "fax_number": "503-612-6948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUALATIN PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-12",
        "last_updated": "2013-12-12",
        "status": "A",
        "authorized_official_last_name": "YARBOROUGH",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "503-692-3747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "D9222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tualatin Eye Associates PC
• Tualatin Imaging P C
• Tualatin Internal Medicine
• Tualatin Medical Suppplies
• Tualatin Modern Dentistry,PC (Tualatin Modern Dentistry)
• Tualatin Physical Therapy & Sports Rehab Inc
• Tualitin Senior Care LLC (River Valley Landing)
• Jasmine C Turley
• John Robert Turner
• Sarah Ann Tycast, MD

• Dental Clinic/Center in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; 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.