NPIMap

Organization Active NPI

Portland Dental Works, LLC

  • General Practice Dentistry
  • Beaverton, OR
National Provider Identifier
1801189386
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PORTLAND DENTAL WORKS, LLC
Practice address
4225 SW 109TH Ave
Beaverton, OR 97005-3028
Phone
(503) 644-3188
Fax
(503) 672-9866
NPI assigned
May 17, 2011
Organization subpart
Yes
Parent organization
PORTLAND DENTAL WORKS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

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

Authorized official

Name
Amelia Schmechel
Title
Practice Manager
Phone
(503) 644-3188

Specialties & licenses 1

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

Addresses

Primary practice location

4225 SW 109TH Ave
Beaverton, OR 97005-3028

Mailing address

4225 SW 109TH Ave
Beaverton, OR 97005-3028
Phone (503) 644-3188

Other names 1

  • Beaverton Dental Works Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Portland Dental Works LLC3 organizations share this tax ID, including this one
Part of
Portland Dental Works LLC

Other organizations with this tax ID 2

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342483200000",
    "number": "1801189386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 SW 109TH AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053028",
            "telephone_number": "503-644-3188",
            "fax_number": "503-672-9866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 SW 109TH AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053028",
            "telephone_number": "503-644-3188",
            "fax_number": "503-672-9866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND DENTAL WORKS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PORTLAND DENTAL WORKS, LLC",
        "enumeration_date": "2011-05-17",
        "last_updated": "2012-07-17",
        "status": "A",
        "authorized_official_last_name": "SCHMECHEL",
        "authorized_official_first_name": "AMELIA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "503-644-3188"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaverton Dental Works",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.