Pediatric Dentistry, RC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D6853 Issued in OR

Legal business name

PEDIATRIC DENTISTRY, RC

Practice address

2824 NE Wasco St
Suite 230
Portland, OR 97232-1772

Phone

(503) 284-5678

NPI assigned

Jun 25, 2008

Last updated

Jun 25, 2008By 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

Noel V Larsen, D.M.DNPI 1437156734

Title

Dentist/Owner of Practice

Phone

(503) 284-5678

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Noel Vee Larsen, D.M.D.

  • Pediatric Dentistry
  • Portland, OR
  • NPI 1437156734
  Authorized official Same address or phone

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1720240427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2824 NE WASCO ST",
            "address_2": "SUITE 230",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321772",
            "telephone_number": "503-284-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2824 NE WASCO ST",
            "address_2": "SUITE 230",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321772",
            "telephone_number": "503-284-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY, RC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "NOEL",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "DENTIST/OWNER OF PRACTICE",
        "authorized_official_telephone_number": "503-284-5678",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D6853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy S Pederson, MD
• Pediatric Associates of the Northwest, PC
• Pediatric Cardiology Center of Oregon PC (Childrens Cardiac Center of Oregon)
• Pediatric Dental Group
• Pediatric Dentistry of Portland LLC
• Pediatric Endocrinology of Portland, P.C.
• Pediatric Intensive Care Trauma Associates PC
• Pediatric Occupational Therapy Solutions, LLC
• Pediatric Orthotic and Prosthetic Services - Northwest, LLC
• Pediatric Sensory Therapy, LLC

• Pediatric Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• Pediatric Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.