Pac Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D8646 Issued in OR

Legal business name

PAC DENTAL

Practice address

2850 SE 82ND Ave
Suite 8
Portland, OR 97266-1599

Phone

(503) 788-1415

NPI assigned

Apr 6, 2007

Organization subpart

No

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

Authorized official

Name

Justin S Lee, DDS

Title

President

Phone

(503) 788-1415

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679696652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 SE 82ND AVE",
            "address_2": "SUITE 8",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972661599",
            "telephone_number": "503-788-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 SE 82ND AVE",
            "address_2": "SUITE 8",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972661599",
            "telephone_number": "503-788-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAC DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-788-1415",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendall Lynne Ozmun
• Arzu Ozturk, M.D.
• Sisii Ozuna
• Mason C Paas, MD
• Philip Paasch, RPH
• Pace Pediatric Therapy, Inc.
• Alyssa Rachael Pace, PA-C
• Lisa Pace, MA
• Martha Pace, ND
• Melody Pace, L.M.T.

• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• 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.