NPIMap

Organization Active NPI

Eric P Bergquam DMD PC

  • General Practice Dentistry
  • Newberg, OR
National Provider Identifier
1780763755
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D8310 Issued in OR
Legal business name
ERIC P BERGQUAM DMD PC
Practice address
906 Deborah Rd
Newberg, OR 97132
Phone
(503) 538-5476
Fax
(503) 538-8293
NPI assigned
Nov 2, 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
Eric P Bergquam, DMDNPI 1194035865
Title
President
Phone
(503) 538-5476

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D8310 OR Primary

Addresses

Primary practice location

906 Deborah Rd
Newberg, OR 97132

Mailing address

906 Deborah Rd
Newberg, OR 97132
Phone (503) 538-5476

National Provider Directory

National Provider Directory

Locations

906 N Deborah Rd
Newberg, OR 97132
Phone (503) 538-5476

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": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780763755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 DEBORAH RD",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "97132",
            "telephone_number": "503-538-5476",
            "fax_number": "503-538-8293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 DEBORAH RD",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "97132",
            "telephone_number": "503-538-5476",
            "fax_number": "503-538-8293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC P BERGQUAM DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERGQUAM",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-538-5476",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberg, 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.