Bruno Cristalli Da Costa, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

8550 Issued in OR

Practice address

2250 NW Flanders St
112
Portland, OR 97210-3443

Phone

(503) 248-1970

Fax

(503) 248-6811

NPI assigned

Jul 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1275532384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 NW FLANDERS ST",
            "address_2": "112",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103443",
            "telephone_number": "503-248-1970",
            "fax_number": "503-248-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 NW FLANDERS ST",
            "address_2": "112",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103443",
            "telephone_number": "503-248-1970",
            "fax_number": "503-248-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DA COSTA",
        "first_name": "BRUNO",
        "middle_name": "CRISTALLI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "8550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annamaria M D'Onofrio
• Andrea Olsen D'Ostroph, M.D.
• Antonio Mario D'Ovidio, DPT
• Christina Maria Rosa D'Ovidio, MD
• Neisha Ann D'Souza, M.D.
• Daniel Inacio Da Graca, M.D.
• Robert Arthur Da Prato, M.D.
• Leo J Daab, M.D.
• Meti F Daba
• Rannah Dabiri, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.