NPIMap

Organization Active NPI

Geriatric Dental Group

  • Dentist
  • Portland, OR
National Provider Identifier
1760441216
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D8295 Issued in OR
Legal business name
GERIATRIC DENTAL GROUP
Practice address
6319 SE Powell Blvd
Portland, OR 97042
Phone
(503) 772-3677
NPI assigned
Mar 22, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Pamela A Linder, EXEC DIR
Title
Exec Dir
Phone
(503) 772-3677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D8295 OR Primary

Addresses

Primary practice location

6319 SE Powell Blvd
Portland, OR 97042

Mailing address

19348 Windmill Dr
Oregon City, OR 92045
Phone (507) 650-5296

National Provider Directory

National Provider Directory
Tax ID family
Geriatric Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 4

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": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760441216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19348 WINDMILL DR",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "92045",
            "telephone_number": "507-650-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6319 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97042",
            "telephone_number": "503-772-3677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRIC DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LINDER",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXEC DIR",
        "authorized_official_telephone_number": "503-772-3677",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "EXEC DIR"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D8295",
            "primary": true
        }
    ],
    "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 Aug 22, 2020; 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.