Fransiskus Andrianto Tjiptowidjojo, D.D.S., M.S.

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

D11565 Issued in OR

Practice address

9300 SE 91St Ave Ste 403
Happy Valley, OR 97086-3762

Phone

(503) 653-2299

Fax

(503) 774-4154

NPI assigned

Jan 11, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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

• Panagiota Stathopoulou DMD LLC

  • Prosthodontics
  • Happy Valley, OR
  • NPI 1790415537
  NPD
• Fusion Dental Specialists

  • Customized Equipment (DME)
  • Happy Valley, OR
  • NPI 1972906428
  NPD (past)
• Summit Oregon LLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Portland, OR
  • NPI 1205664844
  NPD (past)

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

{
    "created_epoch": "1389398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656892800000",
    "number": "1578985495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 SE 91ST AVE STE 403",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970863762",
            "telephone_number": "503-653-2299",
            "fax_number": "503-774-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 SE 91ST AVE STE 403",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970863762",
            "telephone_number": "503-653-2299",
            "fax_number": "503-774-4154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Martin Luther King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482082576",
            "country_code": "US",
            "telephone_number": "313-494-6786",
            "fax_number": "313-494-6781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 N Roselle Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601953179",
            "country_code": "US",
            "telephone_number": "847-885-0105",
            "fax_number": "847-885-9624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TJIPTOWIDJOJO",
        "first_name": "FRANSISKUS ANDRIANTO",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-11",
        "last_updated": "2022-07-04",
        "certification_date": "2022-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MI",
            "license": "2901021710",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "VA",
            "license": "0401414234",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "IL",
            "license": "019.032507",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "OR",
            "license": "D11565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry Lyman Tibbles, M.D.
• Patrick Tierney
• Timber and Iron Physical Therapy LLC
• Sarah Tindall, ND
• Susan Titus, L.P.C.
• Richard Justin Tooke, D.M.D.
• Han Mai Tran
• Jessica Paige Tucker
• Dylan Clune Turner, D.C.
• Theresa Uchison, PSY.D.

• Prosthodontics in Happy Valley, OR
• Providers in Happy Valley, OR by specialty
• Prosthodontics in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.