Maryam M Motlagh, DMD PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7499 Issued in OR

Practice address

13765 NW Cornell Rd
Suite 100
Portland, OR 97229-5300

Phone

(503) 643-9855

Fax

(503) 626-7154

NPI assigned

Dec 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Maryam M. Motlagh DMD PC

  • Dentist
  • Portland, OR
  • NPI 1811154271
  NPD (past) Authorized official

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1467439182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13765 NW CORNELL RD",
            "address_2": "SUITE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295300",
            "telephone_number": "503-643-9855",
            "fax_number": "503-626-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13765 NW CORNELL RD",
            "address_2": "SUITE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295300",
            "telephone_number": "503-643-9855",
            "fax_number": "503-626-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTLAGH",
        "first_name": "MARYAM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "7499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mother Tree International LLC
• Caroline Motika, M.D.
• Paul Motika, M.D.
• Motion Chiropractic LLC
• Rogan Gabriel Motis, MSW
• Heather Mitsuru Motonaga, M.D.
• Allison Jayne Mott, MASSAGE THERAPIST
• Emmalie Mott
• Holly Mott
• Elizabeth M Motteler

• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.