Atlas Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D10274 Issued in OR

Legal business name

ATLAS DENTAL, LLC

Doing business as

oliver station dental

Practice address

5959 SE 92ND Ave Ste 103
Portland, OR 97266-4642

Phone

(971) 279-7753

NPI assigned

Sep 30, 2017

Last updated

Sep 30, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Hieu Pham, DMD

Title

Dentist

Phone

(971) 971-2797

Specialties & licenses 1

Addresses

Other names 1

• oliver station dental Doing business as

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

{
    "created_epoch": "1506729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506729600000",
    "number": "1316457666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 SE 92ND AVE STE 103",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972664642",
            "telephone_number": "971-279-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 SE 92ND AVE STE 103",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972664642",
            "telephone_number": "971-279-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLAS DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-30",
        "last_updated": "2017-09-30",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "HIEU",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "971-971-2797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "oliver station dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2017; 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.