Individual provider Active NPI

Bahar Tajdar, DMD

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1306465729
Registry record updated Jul 30, 2021
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D11364 Issued in OR
Practice address
8931 SE Foster Rd
Portland, OR 97266-4661
Phone
(855) 433-6825
NPI assigned
Apr 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D11364 OR Primary
Dentist 122300000X D11364 OR

Addresses

Primary practice location

8931 SE Foster Rd
Portland, OR 97266-4661

Mailing address

6950 NE Campus Way
Hillsboro, OR 97124-5611
Phone (855) 433-6825

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210125000042 OR Order and Referring Only - DentistPractitioner - Dentist 5890109375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D11364ORMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1306465729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 NE CAMPUS WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245611",
            "telephone_number": "855-433-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8931 SE FOSTER RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972664661",
            "telephone_number": "855-433-6825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAJDAR",
        "first_name": "BAHAR",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-15",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D11364",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11364",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.