Magnolia Family Dentistry, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MAGNOLIA FAMILY DENTISTRY, LLC

Practice address

1791 NW 173Rd Ave Ste 110
Beaverton, OR 97006-5630

Phone

(503) 372-5527

NPI assigned

Dec 5, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Mira Della Croce, DMDNPI 1134439144

Title

Dentist

Phone

(503) 372-5527

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mira Kharoti Della Croce, D.M.D.

  • General Practice Dentistry
  • West Chester, PA
  • NPI 1134439144
  NPD (past) Authorized official

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543968000000",
    "number": "1326518119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1791 NW 173RD AVE STE 110",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970065630",
            "telephone_number": "503-372-5527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1791 NW 173RD AVE STE 110",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970065630",
            "telephone_number": "503-372-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-05",
        "last_updated": "2018-12-05",
        "status": "A",
        "authorized_official_last_name": "DELLA CROCE",
        "authorized_official_first_name": "MIRA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "503-372-5527",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Lee Magee
• Stephanie Magee, LMT
• Casey Ryan Magis-Agosta, CPNP-PC, APRN, MSN
• Jennifer Lee Magneson, MS
• Alexander Magnifique, LMT
• Mah Psychiatric Services Inc (Kids, Inc.)
• Kenneth K.S. Mah, D.P.M.
• Maile D Mahelona, LAC
• Samira Farag Hawash Mahmoud, BCABA
• Camelia Mahmoudian, MD

• Dental Clinic/Center in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; 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.