Organization Active NPI

Emergency Tooth Doctor, P.C.

  • Dentist
  • Beaverton, OR
National Provider Identifier
1679788822
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
EMERGENCY TOOTH DOCTOR, P.C.
Practice address
13779 SW Farmington Rd
Beaverton, OR 97005-2603
Phone
(503) 641-2200
Fax
(503) 641-2220
NPI assigned
May 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Thomas Pham, D.M.D.
Title
Doctor
Phone
(503) 641-2200

Specialties & licenses 1

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

Addresses

Primary practice location

13779 SW Farmington Rd
Beaverton, OR 97005-2603

Mailing address

13779 SW Farmington Rd
Beaverton, OR 97005-2603
Phone (503) 641-2200

National Provider Directory

National Provider Directory

Locations

13779 SW Farmington Rd
Beaverton, OR 97005
Phone (503) 641-2200

Practitioners & affiliated clinicians

Practitioners 1

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": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679788822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13779 SW FARMINGTON RD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052603",
            "telephone_number": "503-641-2200",
            "fax_number": "503-641-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13779 SW FARMINGTON RD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052603",
            "telephone_number": "503-641-2200",
            "fax_number": "503-641-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY TOOTH DOCTOR, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "503-641-2200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • 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.