NPIMap

Organization Active NPI

Serenity Dental, LLC

  • General Practice Dentistry
  • Wilsonville, OR
National Provider Identifier
1710735048
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SERENITY DENTAL, LLC
Practice address
29292 SW Town Center Loop E Ste B
Wilsonville, OR 97070-9491
Phone
(503) 974-0500
Fax
(503) 974-0505
NPI assigned
May 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Authorized official

Name
Dr. Thomas Clark, DMD
Title
DMD
Phone
(503) 974-0500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

29292 SW Town Center Loop E Ste B
Wilsonville, OR 97070-9491

Mailing address

29292 SW Town Center Loop E Ste B
Wilsonville, OR 97070-9491
Phone (503) 974-0500

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1710735048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29292 SW TOWN CENTER LOOP E STE B",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709491",
            "telephone_number": "503-974-0500",
            "fax_number": "503-974-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29292 SW TOWN CENTER LOOP E STE B",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709491",
            "telephone_number": "503-974-0500",
            "fax_number": "503-974-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "DMD",
        "authorized_official_telephone_number": "503-974-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilsonville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.