NPIMap

Organization Active NPI

Dental Professionals of Oregon, P.C.

  • General Practice Dentistry
  • Beaverton, OR
National Provider Identifier
1508484205
Registry record updated Jul 9, 2020
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
12850 SW Canyon Rd Ste a
Beaverton, OR 97005-2166
Phone
(503) 376-8537
NPI assigned
Jul 9, 2020
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF OREGON, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Authorized official

Name
Tabatha Lemke
Title
Credentialing Coordinator
Phone
(217) 540-6078

Specialties & licenses 1

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

Addresses

Primary practice location

12850 SW Canyon Rd Ste a
Beaverton, OR 97005-2166

Mailing address

12850 SW Canyon Rd Ste a
Beaverton, OR 97005-2166
Phone (503) 376-8537

Other names 1

  • Definition Dental 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

12850 SW Canyon Rd
Ste A
Beaverton, OR 97005
Phone (503) 376-8537

NPI Registry JSON

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1508484205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12850 SW CANYON RD STE A",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052166",
            "telephone_number": "503-376-8537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12850 SW CANYON RD STE A",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052166",
            "telephone_number": "503-376-8537"
        }
    ],
    "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": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "LEMKE",
        "authorized_official_first_name": "TABATHA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-6078"
    },
    "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": "Definition Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 9, 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.