Beaverton Orthodontics, PC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D6736 Issued in OR

Legal business name

BEAVERTON ORTHODONTICS, PC

Practice address

14795 SW Murray Scholls Dr
Ste 119
Beaverton, OR 97007-9713

Phone

(503) 524-0524

NPI assigned

Jul 12, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Steven W. BlackNPI 1174530091

Title

President

Phone

(503) 524-0524

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, and the practitioner matching its NPPES authorized official.

• Steven W. Black, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Beaverton, OR
  • NPI 1174530091
  NPD (past) Authorized official

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342051200000",
    "number": "1447515747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1891",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970350612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14795 SW MURRAY SCHOLLS DR",
            "address_2": "STE 119",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970079713",
            "telephone_number": "503-524-0524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVERTON ORTHODONTICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-12",
        "last_updated": "2012-07-12",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-524-0524",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OR",
            "license": "D6736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.