Individual provider Active NPI

Yizhou Zhu, DDS

  • Dentist
  • Clackamas, OR
National Provider Identifier
1689025975
Registry record updated Feb 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D10833 Issued in OR
Practice address
13023 SE 84TH Ave Ste a
Clackamas, OR 97015-9798
Phone
(503) 353-9992
NPI assigned
Jun 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60665299 WA
Dentist 122300000X D10833 OR Primary

Addresses

Primary practice location

13023 SE 84TH Ave Ste a
Clackamas, OR 97015-9798

Mailing address

1481 NW 13TH Ave Apt 838
Portland, OR 97209-3413
Phone (626) 823-7350

Other practice location 1

1405 Rexford Ave
Pasadena, CA 91107-1618
Phone (626) 823-7350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D10833ORMDDentist
DE60665299WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jyz DDS LLC CurrentSince Mar 4, 2021 Accepting new patients

Locations

4413 SE Cesar E Chavez Blvd
Portland, OR 97202
Phone (503) 777-2284

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613865600000",
    "number": "1689025975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 NW 13TH AVE APT 838",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093413",
            "telephone_number": "626-823-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13023 SE 84TH AVE STE A",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159798",
            "telephone_number": "503-353-9992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1405 Rexford Ave",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911071618",
            "country_code": "US",
            "telephone_number": "626-823-7350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZHU",
        "first_name": "YIZHOU",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-28",
        "last_updated": "2021-02-21",
        "certification_date": "2021-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60665299",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2021; 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.