Yvonne Otis, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12203 Issued in OR

Practice address

10300 SE Washington St Ste C101
Portland, OR 97216-2805

Phone

(037) 763-0915

NPI assigned

May 28, 2025

Last updated

Aug 25, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Yvonne Jaqueline Otis Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1748390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1730072968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 SE 11TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142486",
            "telephone_number": "802-595-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 SE WASHINGTON ST STE C101",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162805",
            "telephone_number": "037-763-0915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "113 Valley View Cir",
            "address_purpose": "LOCATION",
            "city": "Barre",
            "state": "VT",
            "postal_code": "056419602",
            "country_code": "US",
            "telephone_number": "802-476-3140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTIS",
        "first_name": "YVONNE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D12203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YVONNE",
            "last_name": "OTIS",
            "middle_name": "JAQUELINE",
            "credential": "YVONNE OTIS DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Carsen Levi Othaire
• Jana Othman
• Khalid M Othman
• Carol L Otis, MD
• Felesia Otis, CADC II
• Mai Otsuki
• Chrissie Ott, MD
• Gail Ott, D.C.
• Gary Y Ott, MD
• Robert L. Ott, D.M.D.

• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.