NPIMap

Organization Active NPI

Oregon Health and Science University

Doing business as DCH Pediatric Dental Surgery

  • Dentist
  • Portland, OR
National Provider Identifier
1609006568
Registry record updated Jul 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
OREGON HEALTH AND SCIENCE UNIVERSITY
Doing business as
DCH Pediatric Dental Surgery
Practice address
700 SW Campus Drive
Mail Code - DC8S
Portland, OR 97239
Phone
(503) 418-5799
NPI assigned
Jul 24, 2009
Last updated
Jul 24, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2009

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

Authorized official

Name
Dr. Jack W Clinton, DMD
Title
Dean
Phone
(503) 494-8801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

700 SW Campus Drive
Mail Code - DC8S
Portland, OR 97239

Mailing address

611 SW Campus Dr
Portland, OR 97239-3001
Phone (503) 418-5799

Other names 1

  • DCH Pediatric Dental Surgery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Oregon Health Sciences University26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

611 SW Campus Dr
Portland, OR 97239
Phone (503) 494-4316

700 SW Campus Dr
#8S
Portland, OR 97239
Phone (503) 418-5799

NPI Registry JSON

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248393600000",
    "number": "1609006568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 SW CAMPUS DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393001",
            "telephone_number": "503-418-5799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SW CAMPUS DRIVE",
            "address_2": "MAIL CODE - DC8S",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97239",
            "telephone_number": "503-418-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON HEALTH AND SCIENCE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-24",
        "last_updated": "2009-07-24",
        "status": "A",
        "authorized_official_last_name": "CLINTON",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DEAN",
        "authorized_official_telephone_number": "503-494-8801",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DCH Pediatric Dental Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; 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.