Avenue Dental Care
Organization Active NPI Dentist · Clackamas, OR
NPI 1306024880 · NPPES record last updated Feb 6, 2008
Key facts
- NPI
- 1306024880
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- D8233 (OR)
- Legal business name
- AVENUE DENTAL CARE
- Practice address
- 10001 SE Sunnyside Rd
Suite 250
Clackamas, OR 97015-5746 - Phone
- (503) 786-3000
- NPI assigned
- Feb 6, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Mahadeep S Virk, DMD
- Title
- Owner
- Phone
- (503) 786-3000
National Provider Directory
Locations
10001 SE Sunnyside Rd
Ste 250
Clackamas, OR 97015
Phone (503) 786-3000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | D8233 | OR | Yes |
Addresses
Primary practice location
10001 SE Sunnyside Rd
Suite 250
Clackamas, OR 97015-5746
Mailing address
10001 SE Sunnyside Rd
Suite 250
Clackamas, OR 97015-5746
Phone (503) 786-3000
Other providers in Clackamas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.