NPIMap

Organization Active NPI

Skyline Oral Facial and Dental Implant Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Portland, OR
National Provider Identifier
1376310359
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
SKYLINE ORAL FACIAL AND DENTAL IMPLANT SURGERY
Practice address
11786 SW Barnes Rd Ste 110
Portland, OR 97225-5926
Phone
(503) 924-2323
NPI assigned
Dec 8, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Authorized official

Name
Mr. Jason Faler
Title
Executive Director
Phone
(503) 444-6444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

11786 SW Barnes Rd Ste 110
Portland, OR 97225-5926

Mailing address

11786 SW Barnes Rd Ste 110
Portland, OR 97225-5926
Phone (503) 924-2323

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1701993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1376310359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11786 SW BARNES RD STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255926",
            "telephone_number": "503-924-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11786 SW BARNES RD STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255926",
            "telephone_number": "503-924-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYLINE ORAL FACIAL AND DENTAL IMPLANT SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-08",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "FALER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "503-444-6444",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "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 Jul 1, 2024; 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.