NPIMap

Organization Active NPI

Gehred Family Dental

  • Dentist
  • Portland, OR
National Provider Identifier
1730497868
Registry record updated Sep 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D9242 Issued in OR
Legal business name
GEHRED FAMILY DENTAL
Practice address
10340 SE Division St
Suite 1
Portland, OR 97266-1269
Phone
(503) 254-2068
Fax
(503) 252-5820
NPI assigned
Sep 23, 2010
Last updated
Sep 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2010

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

Authorized official

Name
Dr. Cornelius Gehred, DDS
Title
President
Phone
(503) 254-2068

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X D9242 OR Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X D8874 OR
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X D4833 OR

Addresses

Primary practice location

10340 SE Division St
Suite 1
Portland, OR 97266-1269

Mailing address

10340 SE Division St
Suite 1
Portland, OR 97266-1269
Phone (503) 254-2068

National Provider Directory

National Provider Directory
Tax ID family
Gehred Family Dental3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10340 SE Division St
Ste 1
Portland, OR 97266
Phone (503) 254-2068

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285200000000",
    "number": "1730497868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10340 SE DIVISION ST",
            "address_2": "SUITE 1",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972661269",
            "telephone_number": "503-254-2068",
            "fax_number": "503-252-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10340 SE DIVISION ST",
            "address_2": "SUITE 1",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972661269",
            "telephone_number": "503-254-2068",
            "fax_number": "503-252-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEHRED FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-23",
        "last_updated": "2010-09-23",
        "status": "A",
        "authorized_official_last_name": "GEHRED",
        "authorized_official_first_name": "CORNELIUS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-254-2068",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9242",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "D8874",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "D4833",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; 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.