Colasurdodmd LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

COLASURDODMD LLC

Doing business as

Vincent Colasurdo

Practice address

833 SW 11TH Ave Ste 723
Portland, OR 97205-2121

Phone

(503) 223-7661

NPI assigned

Oct 19, 2022

Last updated

Oct 19, 2022By 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. Vincent Colasurdo, DMDNPI 1013317676

Title

Dentist

Phone

(503) 680-2972

Specialties & licenses 1

Addresses

Other names 1

• Vincent Colasurdo Doing business as

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.

• Vincent Colasurdo, D.M.D.

  • General Practice Dentistry
  • Portland, OR
  • NPI 1013317676
  NPD Authorized official
• John Gabriel Colasurdo, DMD

  • Dentist
  • Portland, OR
  • NPI 1427150341
  NPD (past)

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666137600000",
    "number": "1275259418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4969 SW 31ST DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972391239",
            "telephone_number": "503-680-2972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 SW 11TH AVE STE 723",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052121",
            "telephone_number": "503-223-7661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLASURDODMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A",
        "authorized_official_last_name": "COLASURDO",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "503-680-2972",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vincent Colasurdo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Gabriel Colasurdo, DMD
• Marco Colasurdo
• Melissa Kay Colasurdo, DMD
• Susan Grover Colasurdo, MD
• Vincent Colasurdo, D.M.D.
• Estefania Colazo
• Isabella Raven Colbert
• Jewell Colbert
• Natalie Marie Colbert
• Tasha Nicole Colbert

• 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 Oct 19, 2022; 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.