Northwest Oral Pathology

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

Legal business name

NORTHWEST ORAL PATHOLOGY

Practice address

12254 SW Garden PL
Tigard, OR 97223-8246

Phone

(503) 906-7300

Fax

(503) 245-8219

NPI assigned

Dec 8, 2016

Organization subpart

No

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

Authorized official

Name

Frank James Kratochvil III, DDS

Title

Owner

Phone

(503) 906-7300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481155200000",
    "number": "1790229888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 230457",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972810457",
            "telephone_number": "503-906-7300",
            "fax_number": "503-245-8219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12254 SW GARDEN PL",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238246",
            "telephone_number": "503-906-7300",
            "fax_number": "503-245-8219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST ORAL PATHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-08",
        "last_updated": "2016-12-08",
        "status": "A",
        "authorized_official_last_name": "KRATOCHVIL",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-906-7300",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Pathology Dentistry in Tigard, OR
• Providers in Tigard, OR by specialty
• Oral and Maxillofacial Pathology Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.