NPIMap

Organization Active NPI

East City Dental

  • Dentist
  • Portland, OR
National Provider Identifier
1679388136
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
EAST CITY DENTAL
Practice address
15925 SE Stark St
Portland, OR 97233-3525
Phone
(503) 253-0291
Fax
(503) 253-1096
NPI assigned
Feb 11, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Authorized official

Name
Dakota H.
Title
Office Manager
Phone
(503) 253-0291

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

15925 SE Stark St
Portland, OR 97233-3525

Mailing address

15925 SE Stark St
Portland, OR 97233-3525
Phone (503) 253-0291

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1739232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739232000000",
    "number": "1679388136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15925 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972333525",
            "telephone_number": "503-253-0291",
            "fax_number": "503-253-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15925 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972333525",
            "telephone_number": "503-253-0291",
            "fax_number": "503-253-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST CITY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A",
        "authorized_official_last_name": "H.",
        "authorized_official_first_name": "DAKOTA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-253-0291"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "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 Feb 11, 2025; 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.