NPIMap

Organization Active NPI

Tiffany Goldwyn DMD PC

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1316540826
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TIFFANY GOLDWYN DMD PC
Practice address
1616 SW Sunset Blvd Ste B
Portland, OR 97239-2641
Phone
(503) 244-8112
NPI assigned
Nov 18, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Authorized official

Name
Dr. Tiffany Goldwyn, DMDNPI 1396835450
Title
President
Phone
(503) 244-8112

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1616 SW Sunset Blvd Ste B
Portland, OR 97239-2641

Mailing address

1616 SW Sunset Blvd Ste B
Portland, OR 97239-2641
Phone (503) 244-8112

National Provider Directory

National Provider Directory

Locations

1616 SW Sunset Blvd
Ste B
Portland, OR 97239
Phone (503) 244-8112

Practitioners & affiliated clinicians

Practitioners 2

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": "1605657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1316540826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 SW SUNSET BLVD STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392641",
            "telephone_number": "503-244-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 SW SUNSET BLVD STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392641",
            "telephone_number": "503-244-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFFANY GOLDWYN DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-17",
        "status": "A",
        "authorized_official_last_name": "GOLDWYN",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-244-8112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.