Active NPI
Matthew Donovan Goodhue, DMD
- Dentist
- Lake Oswego, OR
National Provider Identifier
1558570622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D7615
- Practice address
- 17050 Pilkington Rd.
Suite 230
Lake Oswego, OR 97035 - Phone
- (503) 636-6644
- Fax
- (503) 635-3099
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D7615 | OR | Primary |
Addresses
Primary practice location
17050 Pilkington Rd.
Suite 230
Lake Oswego, OR 97035
Mailing address
17050 Pilkington Rd.
Suite 230
Lake Oswego, OR 97035
Phone (503) 636-6644
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 27, 2026 through Feb 27, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D7615 | OR | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1558570622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17050 PILKINGTON RD.",
"address_2": "SUITE 230",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "97035",
"telephone_number": "503-636-6644",
"fax_number": "503-635-3099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17050 PILKINGTON RD.",
"address_2": "SUITE 230",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "97035",
"telephone_number": "503-636-6644",
"fax_number": "503-635-3099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODHUE",
"first_name": "MATTHEW",
"middle_name": "DONOVAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D7615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Oswego, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.