Active NPI
Barry Orrick Evans, DMD
- Dentist
- Portland, OR
National Provider Identifier
1639169121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4423
- Practice address
- 12887 NW Cornell Rd
Portland, OR 97229-5813 - Phone
- (503) 644-3105
- Fax
- (503) 619-0066
- NPI assigned
- Oct 26, 2005
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4423 | OR | Primary |
Addresses
Primary practice location
12887 NW Cornell Rd
Portland, OR 97229-5813
Mailing address
12887 NW Cornell Rd
Portland, OR 97229-5813
Phone (503) 644-3105
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4423 | OR | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1639169121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12887 NW CORNELL RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972295813",
"telephone_number": "503-644-3105",
"fax_number": "503-619-0066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12887 NW CORNELL RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972295813",
"telephone_number": "503-644-3105",
"fax_number": "503-619-0066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "BARRY",
"middle_name": "ORRICK",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-26",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "4423",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.