NPIMap

Organization Active NPI

Bradley S. McAllister, DDS, PHD

Doing business as Periodontal Associates

  • Dental Clinic/Center
  • Tigard, OR
National Provider Identifier
1295798452
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D6900 Issued in OR
Legal business name
BRADLEY S. MCALLISTER, DDS, PHD
Doing business as
Periodontal Associates
Practice address
11525 SW Durham Rd
Suite D-6
Tigard, OR 97224-3475
Phone
(503) 620-2807
Fax
(503) 968-5419
NPI assigned
Apr 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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

Authorized official

Name
Dr. Bradley S. McAllister, DDS, PHDNPI 1922387240
Title
Owner
Phone
(503) 620-2807

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D6900 OR Primary

Addresses

Primary practice location

11525 SW Durham Rd
Suite D-6
Tigard, OR 97224-3475

Mailing address

11525 SW Durham Rd
Suite D-6
Tigard, OR 97224-3475
Phone (503) 620-2807

Other names 1

  • Periodontal Associates Doing business as

National Provider Directory

National Provider Directory

Locations

11525 SW Durham Rd
Ste D6
Tigard, OR 97224
Phone (503) 620-2807

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309392000000",
    "number": "1295798452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11525 SW DURHAM RD",
            "address_2": "SUITE D-6",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972243475",
            "telephone_number": "503-620-2807",
            "fax_number": "503-968-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11525 SW DURHAM RD",
            "address_2": "SUITE D-6",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972243475",
            "telephone_number": "503-620-2807",
            "fax_number": "503-968-5419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY S. MCALLISTER, DDS, PHD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2011-06-30",
        "status": "A",
        "authorized_official_last_name": "MCALLISTER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-620-2807",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, PHD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "D6900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Periodontal Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.