Eastside Dental Clinic

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

EASTSIDE DENTAL CLINIC

Practice address

1540 SW 257TH Ave
Troutdale, OR 97060-7412

Phone

(503) 665-2177

Fax

(503) 666-7130

NPI assigned

Aug 9, 2005

Reactivated

Jan 30, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John H Kilian, DMDNPI 1245431162

Title

Dentist Owner

Phone

(503) 665-2177

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Henry Kilian, D.M.D

  • General Practice Dentistry
  • Troutdale, OR
  • NPI 1245431162
  NPD (past) Authorized official
• Jordan Anderson, D.D.S.

  • Dentist
  • Ridgefield, WA
  • NPI 1013344498
  NPD (past)

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1689675167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 700",
            "city": "TROUTDALE",
            "state": "OR",
            "postal_code": "970600700",
            "telephone_number": "503-665-2177",
            "fax_number": "503-666-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 SW 257TH AVE",
            "city": "TROUTDALE",
            "state": "OR",
            "postal_code": "970607412",
            "telephone_number": "503-665-2177",
            "fax_number": "503-666-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2022-07-21",
        "deactivation_date": "2007-01-03",
        "reactivation_date": "2007-01-30",
        "status": "A",
        "authorized_official_last_name": "KILIAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "503-665-2177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jan M Deroest, PSY.D.
• Harpreet Kaur Dhillon, D.O.
• Jessie E Dolan, LMT
• Shaylee Mikayla Dukes
• East Wind Care LLC
• Julie Dawn Elbon, D.C
• Martin Estrada, CADCI, CPS
• James Bruce Eubanks Sr., D.O.
• Eye Health Northwest Optical, LLC
• Eye Health Northwest P.C.

• General Practice Dentistry in Troutdale, OR
• Providers in Troutdale, 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 Jul 21, 2022; 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.