NPIMap

Organization Active NPI

Northwest Oral & Maxillofacial Surgeons, LLC

  • Oral and Maxillofacial Pathology Dentistry
  • Gresham, OR
National Provider Identifier
1629286273
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
D4283 Issued in OR
Legal business name
NORTHWEST ORAL & MAXILLOFACIAL SURGEONS, LLC
Practice address
24850 SE Stark St
Suite 100
Gresham, OR 97030-8316
Phone
(503) 665-7882
Fax
(503) 665-6983
NPI assigned
May 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Henry C. Windell, DMD
Title
Partner
Phone
(503) 665-7882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0106X D4283 OR Primary

Addresses

Primary practice location

24850 SE Stark St
Suite 100
Gresham, OR 97030-8316

Mailing address

24850 SE Stark St
Suite 100
Gresham, OR 97030-8316
Phone (503) 665-7882

National Provider Directory

National Provider Directory
Tax ID family
Beacon Oral and Maxillofacial Surgeons2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629286273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24850 SE STARK ST",
            "address_2": "SUITE 100",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308316",
            "telephone_number": "503-665-7882",
            "fax_number": "503-665-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24850 SE STARK ST",
            "address_2": "SUITE 100",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308316",
            "telephone_number": "503-665-7882",
            "fax_number": "503-665-6983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST ORAL & MAXILLOFACIAL SURGEONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WINDELL",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "503-665-7882",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "OR",
            "license": "D4283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • 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.