NPIMap

Organization Active NPI

Gresham Modern Dentistry, PC

  • Dentist
  • Gresham, OR
National Provider Identifier
1760728786
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
GRESHAM MODERN DENTISTRY, PC
Practice address
387 NE 223Rd Ave
Gresham, OR 97030-8554
Phone
(503) 491-5450
Fax
(503) 491-5452
NPI assigned
Dec 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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

Authorized official

Name
Dr. Richard I Ashton II, DMD
Title
Owner Doctor
Phone
(503) 491-5450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

387 NE 223Rd Ave
Gresham, OR 97030-8554

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

  • Gresham Modern Dentistry, PC Doing business as

National Provider Directory

National Provider Directory

Locations

387 NE 223rd Ave
Gresham, OR 97030
Phone (503) 491-5450

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388448000000",
    "number": "1760728786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 NE 223RD AVE",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308554",
            "telephone_number": "503-491-5450",
            "fax_number": "503-491-5452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRESHAM MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-19",
        "last_updated": "2013-12-31",
        "status": "A",
        "authorized_official_last_name": "ASHTON II",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "503-491-5450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gresham Modern Dentistry, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2013; 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.