NPIMap

Organization Active NPI

Portland Dental Anesthesia

  • Dental Anesthesiology
  • Sherwood, OR
National Provider Identifier
1639604689
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AnesthesiologyTaxonomy code 1223D0004X
License
D9387 Issued in OR
Legal business name
PORTLAND DENTAL ANESTHESIA
Practice address
21370 SW Langer Farms Pkwy #142
Sherwood, OR 97140-9137
Phone
(503) 858-4880
Fax
(503) 914-6685
NPI assigned
Apr 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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

Authorized official

Name
Dr. Ryan T Allred, DMD
Title
Owner
Phone
(503) 858-4880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental AnesthesiologyGroup: 193400000X SINGLE SPECIALTY GROUP 1223D0004X D9387 OR Primary

Addresses

Primary practice location

21370 SW Langer Farms Pkwy #142
Sherwood, OR 97140-9137

Mailing address

21370 SW Langer Farms Pkwy #142
Sherwood, OR 97140-9137
Phone (503) 858-4880

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1639604689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21370 SW LANGER FARMS PKWY #142",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971409137",
            "telephone_number": "503-858-4880",
            "fax_number": "503-914-6685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21370 SW LANGER FARMS PKWY #142",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971409137",
            "telephone_number": "503-858-4880",
            "fax_number": "503-914-6685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND DENTAL ANESTHESIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-27",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "ALLRED",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-858-4880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "OR",
            "license": "D9387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherwood, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.