Powell Dental P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

7887 Issued in OR

Legal business name

POWELL DENTAL P.C.

Practice address

3435 SE 75TH Ave
Portland, OR 97206-2407

Phone

(503) 777-5544

Fax

(503) 777-0460

NPI assigned

May 24, 2007

Organization subpart

No

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

Authorized official

Name

Ryan Blair, D.M.D

Title

Dentist

Phone

(503) 777-5544

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568673283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 SE 75TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972062407",
            "telephone_number": "503-777-5544",
            "fax_number": "503-777-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 SE 75TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972062407",
            "telephone_number": "503-777-5544",
            "fax_number": "503-777-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWELL DENTAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "503-777-5544",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "7887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan James Poulo, MD
• Avery C Poulsen
• Gwynna None Pound, COTA
• Mastaneh Pournaderi, D.D.S
• Irene G. Powch, PH.D.
• Powell Dental Specialties
• Powell Family Dental
• Powell Pharmacy, LLC
• Randi Lyn Powell Sexton, NP
• Kenneth Powell-Wilson

• 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 Aug 22, 2020; 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.