Brookside Dental-Gresham

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

D7444 Issued in OR

Legal business name

BROOKSIDE DENTAL-GRESHAM

Practice address

4255 SE 182ND Ave
Gresham, OR 97030-5083

Phone

(503) 666-2515

Fax

(503) 618-9254

NPI assigned

Mar 4, 2014

Last updated

Mar 4, 2014By 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. Brian Reed Westover, D,M,DNPI 1376532291

Title

Owner/Dentist

Phone

(503) 723-8722

Specialties & licenses 1

Addresses

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.

• Brian Reid Westover, DMD

  • General Practice Dentistry
  • West Linn, OR
  • NPI 1376532291
  Authorized official Same address or phone
• Jeremy Martin Starr, D.D.S.

  • General Practice Dentistry
  • Rocklin, CA
  • NPI 1508298514
  NPD (past)

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393891200000",
    "number": "1700201464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 SE 182ND AVE",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305083",
            "telephone_number": "503-666-2515",
            "fax_number": "503-618-9254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 SE 182ND AVE",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305083",
            "telephone_number": "503-666-2515",
            "fax_number": "503-618-9254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSIDE DENTAL-GRESHAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-04",
        "last_updated": "2014-03-04",
        "status": "A",
        "authorized_official_last_name": "WESTOVER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "REED",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "503-723-8722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D,M,D"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "OR",
            "license": "D7444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shandara Brizzee
• David Brockman, PT, DPT
• Brookdale Senior Living Communities, Inc. (Brookdale Mt. Hood)
• Tyler Brookings, DC
• Margeaux Danielle Brooks, PA
• Greg Brophy, OD
• Luz Maria Brousseau, LPN
• Gabrielle Noel Brown-Wing, LMT
• Alexis Lauren Brown, LCSW
• Carrie Maiorana Brown, M.D.

• Public Health Dentistry in Gresham, OR
• Providers in Gresham, OR by specialty
• Public Health Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; 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.