Periodontal Associates, LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

D6900 Issued in OR

Legal business name

PERIODONTAL ASSOCIATES, LLC

Practice address

18753 SW Martinazzi Ave
Tualatin, OR 97062-6808

Phone

(503) 620-2807

Fax

(503) 968-5419

NPI assigned

Jan 30, 2013

Organization subpart

No

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

Authorized official

Name

Bradley McAllister, DDS, PHDNPI 1922387240

Title

Partner

Phone

(503) 620-2807

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Bradley McAllister, DDS,PHD

  • Periodontics
  • Tigard, OR
  • NPI 1922387240
  NPD (past) Authorized official
• Vahid Thomas Eshraghi, D.M.D

  • Periodontics
  • Tualatin, OR
  • NPI 1346317948
  NPD (past)

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440374400000",
    "number": "1669710331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18753 SW MARTINAZZI AVE",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970626808",
            "telephone_number": "503-620-2807",
            "fax_number": "503-620-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18753 SW MARTINAZZI AVE",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970626808",
            "telephone_number": "503-620-2807",
            "fax_number": "503-968-5419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-30",
        "last_updated": "2015-08-24",
        "status": "A",
        "authorized_official_last_name": "MCALLISTER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "503-620-2807",
        "authorized_official_credential": "DDS, PHD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "OR",
            "license": "D6900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan Lundeen Pence, MA
• Kayla L Pennington, RN, BSN, MS, CRNA
• Claudia Raquel Perfecto
• Performance and Spine Chiropractic Center, LLC
• Performance Modalities Inc
• Gail Peterson Frey, OT
• Candace L Peterson, DMD
• Dean Kyle Peterson, MD
• Heather Wehling Peterson
• Jenna Peterson, M.D.

• Periodontics in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Periodontics in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.