NPIMap

Organization Active NPI

Waterhouse Family Dental, Inc.

  • General Practice Dentistry
  • Beaverton, OR
National Provider Identifier
1437323839
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7425 Issued in OR
Legal business name
WATERHOUSE FAMILY DENTAL, INC.
Practice address
16055 SW Regatta LN
Ste 800
Beaverton, OR 97006-8303
Phone
(503) 614-0454
Fax
(503) 614-9874
NPI assigned
Apr 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Authorized official

Name
Dr. Mohammad H Fotouhi, D.D.S.
Title
Dentist
Phone
(503) 614-0454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D7425 OR Primary

Addresses

Primary practice location

16055 SW Regatta LN
Ste 800
Beaverton, OR 97006-8303

Mailing address

16055 SW Regatta LN
Ste 800
Beaverton, OR 97006-8303
Phone (503) 614-0454

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1437323839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16055 SW REGATTA LN",
            "address_2": "STE 800",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970068303",
            "telephone_number": "503-614-0454",
            "fax_number": "503-614-9874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16055 SW REGATTA LN",
            "address_2": "STE 800",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970068303",
            "telephone_number": "503-614-0454",
            "fax_number": "503-614-9874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERHOUSE FAMILY DENTAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-16",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "FOTOUHI",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "503-614-0454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; 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.