NPIMap

Organization Active NPI

Dr. Timothy J Elliott DMD, PC

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1366708372
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D5163 Issued in OR
Legal business name
DR. TIMOTHY J ELLIOTT DMD, PC
Practice address
202 NE 181St Ave Ste a
Portland, OR 97230-6664
Phone
(503) 661-6111
NPI assigned
Apr 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Authorized official

Name
Timothy J ElliottNPI 1932428794
Title
Owner
Phone
(503) 661-6111

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 D5163 OR Primary

Addresses

Primary practice location

202 NE 181St Ave Ste a
Portland, OR 97230-6664

Mailing address

202 NE 181St Ave Ste a
Portland, OR 97230-6664
Phone (503) 661-6111

National Provider Directory

National Provider Directory

Locations

202 NE 181st Ave
Ste A
Portland, OR 97230
Phone (503) 661-6111

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": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1366708372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 NE 181ST AVE STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972306664",
            "telephone_number": "503-661-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 NE 181ST AVE STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972306664",
            "telephone_number": "503-661-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. TIMOTHY J ELLIOTT DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-661-6111"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D5163",
            "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 Apr 3, 2012; 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.