Lake Oswego Modern Dentistry, PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

LAKE OSWEGO MODERN DENTISTRY, PC

Doing business as

Lake Oswego Modern Dentistry

Practice address

4823 Meadows Rd Ste 131
Lake Oswego, OR 97035-2622

Phone

(503) 334-0351

NPI assigned

Dec 12, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Darioush Afshar, DMD

Title

Owner Doctor

Phone

(503) 334-0351

Specialties & licenses 1

Addresses

Other names 1

• Lake Oswego Modern Dentistry Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Syed Husain Asghar, MD, DMD, BDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Lake Oswego, OR
  • NPI 1821462821
  NPD
• Runaz Barzangy, DMD

  • General Practice Dentistry
  • Lake Oswego, OR
  • NPI 1861177917
  NPD
• Joyce Lynette Nimmo, DMD

  • General Practice Dentistry
  • Seattle, WA
  • NPI 1962137356
  NPD (past)

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1538707294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4823 MEADOWS RD STE 131",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352622",
            "telephone_number": "503-334-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE OSWEGO MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-12",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A",
        "authorized_official_last_name": "AFSHAR",
        "authorized_official_first_name": "DARIOUSH",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "503-334-0351",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Oswego Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake Oswego Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.