Individual provider Active NPI

Eric Daniel Christensen, DMD

  • General Practice Dentistry
  • Beaverton, OR
National Provider Identifier
1477220291
Registry record updated Aug 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D11526 Issued in OR
Practice address
2905 SW Cedar Hills Blvd
Beaverton, OR 97005-1470
Phone
(150) 339-6407
NPI assigned
Aug 28, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D11526 OR Primary

Addresses

Primary practice location

2905 SW Cedar Hills Blvd
Beaverton, OR 97005-1470

Mailing address

4940 SW Dogwood LN
Portland, OR 97225-1414
Phone (209) 969-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D11526ORMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1630108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630108800000",
    "number": "1477220291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 SW DOGWOOD LN",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251414",
            "telephone_number": "209-969-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 SW CEDAR HILLS BLVD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970051470",
            "telephone_number": "150-339-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "ERIC",
        "middle_name": "DANIEL",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-28",
        "last_updated": "2021-08-28",
        "certification_date": "2021-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D11526",
            "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 Aug 28, 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.