Columbia River Dentistry-Gresham, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

COLUMBIA RIVER DENTISTRY-GRESHAM, LLC

Practice address

1700 NW Civic Dr Ste 320
Gresham, OR 97030-3774

Phone

(503) 666-5200

NPI assigned

Sep 17, 2019

Last updated

Sep 17, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Debbie Lopez

Title

Regional Manager

Phone

(503) 914-8221

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568678400000",
    "number": "1508416041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW CIVIC DR STE 320",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303774",
            "telephone_number": "503-666-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 NW CIVIC DR STE 320",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303774",
            "telephone_number": "503-666-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA RIVER DENTISTRY-GRESHAM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-17",
        "last_updated": "2019-09-17",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "503-914-8221"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Gresham",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Gresham",
            "address_1": "1700 NW Civic Dr Ste 320",
            "city": "Gresham",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970303774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephanie Collins, BA IN PSYCHOLOGY
• Sandra Ann Collis, DO
• Columbia Medical and Endocrine Clinic
• Columbia Pain and Spine Institute
• Columbia Pain and Spine Institute
• Columbia Surgical Specialists PLLC
• Tyrell Anthony Comeaux, MS, RD
• Complete Eye Care, Inc.
• Complete Family Healthcare, PC
• Christopher Grant Conley

• Dental Clinic/Center in Gresham, OR
• Providers in Gresham, OR by specialty
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; 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.