NPIMap

Organization Active NPI

Portland Orthodontic Group, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Portland, OR
National Provider Identifier
1447848023
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
PORTLAND ORTHODONTIC GROUP, LLC
Practice address
3332 N Lombard St Ste B
Portland, OR 97217-1258
Phone
(503) 289-1992
NPI assigned
Jan 8, 2021
Last updated
Jan 8, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
PORTLAND ORTHODONTIC GROUP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Authorized official

Name
Dr. Jennifer Crowe, DDSNPI 1568796274
Title
Managing Member/Orthodontist
Phone
(503) 289-1992

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
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

3332 N Lombard St Ste B
Portland, OR 97217-1258

Mailing address

3332 N Lombard St Ste B
Portland, OR 97217-1258
Phone (503) 289-1992

National Provider Directory

National Provider Directory
Tax ID family
Portland Orthodontic Group LLC2 organizations share this tax ID, including this one
Part of
Portland Orthodontic Group LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610064000000",
    "number": "1447848023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3332 N LOMBARD ST STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972171258",
            "telephone_number": "503-289-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3332 N LOMBARD ST STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972171258",
            "telephone_number": "503-289-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND ORTHODONTIC GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PORTLAND ORTHODONTIC GROUP, LLC",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A",
        "authorized_official_last_name": "CROWE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGING MEMBER/ORTHODONTIST",
        "authorized_official_telephone_number": "503-289-1992",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "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 Jan 8, 2021; 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.