NW Portland Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

NW PORTLAND DENTAL LLC

Practice address

2250 NW Flanders St Ste 109
Portland, OR 97210-5409

Phone

(503) 228-6294

NPI assigned

May 22, 2023

Last updated

May 22, 2023By 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

Sean Wasden

Title

Coo

Phone

(208) 965-9415

Specialties & licenses 1

Addresses

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.

• Richard L Dietrich, D.M.D.

  • General Practice Dentistry
  • Portland, OR
  • NPI 1992859920
  NPD (past)
• Geoffrey Neal Purcell, DDS

  • General Practice Dentistry
  • Beaverton, OR
  • NPI 1841828522
  NPD (past)

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1538851241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 3RD ST S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 NW FLANDERS ST STE 109",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105409",
            "telephone_number": "503-228-6294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NW PORTLAND DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "WASDEN",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "208-965-9415"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NW Medical Center
• NW Neurophysiology Consultants
• NW Neurosurgery LLC
• NW Occupational Medicine Center
• NW Pediatrics Integrative Medicine LLC (NW Pediatrics Integrative Medicine)
• NW Portland Holistic Counseling
• NW Portland Tendercare Dental PC
• NW Psychiatric & Mental Health Services (Jean A Daniels)
• NW Residential Support LLC
• NW Rresidential Support LLC

• 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 May 22, 2023; 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.