NPIMap

Organization Active NPI

Dental Professionals of Oregon, P.C.

  • General Practice Dentistry
  • Happy Valley, OR
National Provider Identifier
1477049674
Registry record updated Aug 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF OREGON, P.C.
Practice address
14679 SE Sunnyside Rd Ste D
Happy Valley, OR 97015
Phone
(217) 540-5100
NPI assigned
Jul 11, 2018
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF OREGON, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 6, 2018

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

Authorized official

Name
Jessica Britt
Title
Credentialing Coordinator
Phone
(217) 540-8426

Specialties & licenses 1

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

Addresses

Primary practice location

14679 SE Sunnyside Rd Ste D
Happy Valley, OR 97015

Mailing address

14679 SE Sunnyside Rd Ste D
Happy Valley, OR 97015-6507
Phone (503) 427-9528

Other names 1

  • Sunridge Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Oregon PC11 organizations share this tax ID, including this one
Part of
Dental Professionals of Oregon PC

Other organizations with this tax ID 10

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

Locations

14679 SE Sunnyside Rd
Ste D
Happy Valley, OR 97015
Phone (503) 427-9528

Practitioners & affiliated clinicians

Practitioners 1

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": "1531267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533513600000",
    "number": "1477049674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14679 SE SUNNYSIDE RD STE D",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970156507",
            "telephone_number": "503-427-9528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14679 SE SUNNYSIDE RD STE D",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "97015",
            "telephone_number": "217-540-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF OREGON, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF OREGON, P.C.",
        "enumeration_date": "2018-07-11",
        "last_updated": "2018-08-06",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8426"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunridge Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Happy Valley, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; 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.