Kirk Christianson, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

FC3623053 Issued in OR

Practice address

511 SW 10TH Ave
Suite 1114
Portland, OR 97205-2712

Phone

(503) 228-4122

Fax

(503) 228-2036

NPI assigned

Apr 6, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lance D. Bailey DDS PC

  • General Practice Dentistry
  • Portland, OR
  • NPI 1518108885
  NPD (past)

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1568585594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 SW 10TH AVE STE 1114",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052712",
            "telephone_number": "503-228-4122",
            "fax_number": "503-228-2036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 SW 10TH AVE",
            "address_2": "SUITE 1114",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052712",
            "telephone_number": "503-228-4122",
            "fax_number": "503-228-2036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11719 NE 95th St",
            "address_2": "Suite J",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986822444",
            "country_code": "US",
            "telephone_number": "360-256-4310",
            "fax_number": "360-944-8234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTIANSON",
        "first_name": "KIRK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "FC3623053",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9563",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1568585594",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "FC3623053",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandy Christiansen, M.D.
• Spencer Christiansen
• Cathy Marie Christianson
• David Val Christianson, D.D.S.
• Jamie Nicole Christianson, CHW, CADC 1
• Kirsten A Christianson, CRNA
• Leslie James Christianson, DO
• Penelope Christianson, MDIV PSYD
• Ryan Christianson
• Catherine Christie, MD

• Dentist in Portland, OR
• Providers in Portland, OR by specialty
• Dentist 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.