Dmitri Vladislavovich Aleksandrov, DMD
Individual provider Active NPI General Practice Dentistry · Gresham, OR
NPI 1598854929 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1598854929
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D8451 (OR)
- Practice address
- 600 NE 8TH St Ste 210
Gresham, OR 97030-7341 - Phone
- (503) 988-4900
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151110002805 | OR | Order and Referring Only - Dentist |
7214247865 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D8451 | OR | Yes |
Addresses
Primary practice location
600 NE 8TH St Ste 210
Gresham, OR 97030-7341
Mailing address
1717 SW Park Ave Apt 505
Portland, OR 97201-3237
Phone (503) 679-0865
Other providers in Gresham, OR
- Talia Marie Thelen Akre
- Nichole N Albelo
- Jeffreys D Albright
- Emily Alderaen
- Lauren M Alderson
- Deborah A Alexander
- Jarod Christopher Alford
- George Alkhouri
- Lujein Solaiman Alkreidi
- All Manual Therapy
All providers in Gresham, OR · General Practice Dentistry in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.