Clackamas Town Dental, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CLACKAMAS TOWN DENTAL, LLC

Practice address

9225 SE Sunnyside Road
Clackamas, OR 97086

Phone

(503) 905-3380

NPI assigned

Oct 15, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Sarah Nichol, DDS

Title

Director of Finances

Phone

(503) 880-8581

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350259200000",
    "number": "1699027672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9225 SE SUNNYSIDE ROAD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "97015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9225 SE SUNNYSIDE ROAD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "97086",
            "telephone_number": "503-905-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLACKAMAS TOWN DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-15",
        "last_updated": "2012-10-15",
        "status": "A",
        "authorized_official_last_name": "NICHOL",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCES",
        "authorized_official_telephone_number": "503-880-8581",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.