NPIMap

Organization Active NPI

Portland Dental Center

  • Dentist
  • Portland, OR
National Provider Identifier
1689929838
Registry record updated Jul 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D9662 Issued in OR
Legal business name
PORTLAND DENTAL CENTER
Practice address
4301 NE Tillamook St.
Portland, OR 97213-1315
Phone
(503) 331-1322
Fax
(503) 331-1252
NPI assigned
Jul 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2012

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

Authorized official

Name
Dr. Man Van Chau, D.M.D.
Title
Dentist
Phone
(503) 331-1322

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D9662 OR Primary

Addresses

Primary practice location

4301 NE Tillamook St.
Portland, OR 97213-1315

Mailing address

4301 NE Tillamook St.
Portland, OR 97213-1315
Phone (503) 331-1322

National Provider Directory

National Provider Directory

Locations

4301 NE Tillamook St
Portland, OR 97213
Phone (503) 331-1322

NPI Registry JSON

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342137600000",
    "number": "1689929838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 NE TILLAMOOK ST.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131315",
            "telephone_number": "503-331-1322",
            "fax_number": "503-331-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 NE TILLAMOOK ST.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131315",
            "telephone_number": "503-331-1322",
            "fax_number": "503-331-1252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-13",
        "last_updated": "2012-07-13",
        "status": "A",
        "authorized_official_last_name": "CHAU",
        "authorized_official_first_name": "MAN",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "503-331-1322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9662",
            "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 Jul 13, 2012; 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.