Powell Dental Specialties

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

D7799 Issued in OR

Legal business name

POWELL DENTAL SPECIALTIES

Practice address

12661 SE Powell Blvd Ste D
Portland, OR 97236-3400

Phone

(503) 760-1880

Fax

(503) 775-6849

NPI assigned

Jan 14, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Tony Gaby Bassili, DMD

Title

Endodontist

Phone

(503) 432-3997

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1358121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358121600000",
    "number": "1306183074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12661 SE POWELL BLVD STE D",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972363400",
            "telephone_number": "503-760-1880",
            "fax_number": "503-775-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12661 SE POWELL BLVD STE D",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972363400",
            "telephone_number": "503-760-1880",
            "fax_number": "503-775-6849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWELL DENTAL SPECIALTIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-14",
        "last_updated": "2013-01-14",
        "status": "A",
        "authorized_official_last_name": "BASSILI",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "GABY",
        "authorized_official_title_or_position": "ENDODONTIST",
        "authorized_official_telephone_number": "503-432-3997",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "OR",
            "license": "D7799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avery C Poulsen
• Gwynna None Pound, COTA
• Mastaneh Pournaderi, D.D.S
• Irene G. Powch, PH.D.
• Powell Dental P.C.
• Powell Family Dental
• Powell Pharmacy, LLC
• Randi Lyn Powell Sexton, NP
• Kenneth Powell-Wilson
• Alice Karlin Powell, MA CLINICAL SOC WORK

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.