Individual provider Active NPI

Charles Gilbert Row

  • General Practice Dentistry
  • Clackamas, OR
National Provider Identifier
1588677074
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8675 Issued in OR
Practice address
10209 SE Sunnyside Rd
Clackamas, OR 97015-9782
Phone
(503) 353-3900
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8675 OR Primary

Addresses

Primary practice location

10209 SE Sunnyside Rd
Clackamas, OR 97015-9782

Mailing address

7415 SE 18TH Ave
Portland, OR 97202-6134
Phone (503) 235-5038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20110718000241 OR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1658549712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8675ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Permamante Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588677074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7415 SE 18TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972026134",
            "telephone_number": "503-235-5038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10209 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159782",
            "telephone_number": "503-353-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROW",
        "first_name": "CHARLES",
        "middle_name": "GILBERT",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "8675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.