Portland Dental Associates PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PORTLAND DENTAL ASSOCIATES PC

Doing business as

Teamsters Dental Center

Practice address

1890 NE 162ND Ave
Portland, OR 97230-5642

Phone

(503) 257-9836

Fax

(503) 257-3723

NPI assigned

Mar 13, 2007

Last updated

Jul 21, 2022By 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

Dr. Farid Bolouri, DMD

Title

Dental Director Dentist

Phone

(503) 257-9836

Specialties & licenses 1

Addresses

Other names 1

• Teamsters Dental Center Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Oliver Winslow Graumann, DDS

  • Dentist
  • Portland, OR
  • NPI 1801782008
  NPD (past)
• Breanna Aileen Vogel, RDH

  • Dental Hygienist
  • Portland, OR
  • NPI 1093608218
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1518090323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 NE 162ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972305642",
            "telephone_number": "503-257-9836",
            "fax_number": "503-257-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 NE 162ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972305642",
            "telephone_number": "503-257-9836",
            "fax_number": "503-257-3723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND DENTAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BOLOURI",
        "authorized_official_first_name": "FARID",
        "authorized_official_title_or_position": "DENTAL DIRECTOR DENTIST",
        "authorized_official_telephone_number": "503-257-9836",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teamsters Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Portland Compassionate Care Consulting
• Portland Compounding Pharmacy LLC (Lloyd Center Pharmacy)
• Portland Dart Schools
• Portland DBT Institute, Inc. (Portland DBT Institute of Salem)
• Portland Dental and Naturopathic Clinic
• Portland Dental Center
• Portland Dental LLC
• Portland Dental Smiles
• Portland Dental Works, LLC (Portland Dental Works)
• Portland Dermatology Clinic, LLP

• Dental Clinic/Center in Portland, OR
• Providers in Portland, 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 Jul 21, 2022; 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.