Active NPI
Garrett Masuda, DDS, MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Portland, OR
National Provider Identifier
1801517255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- D12113
- Practice address
- 4419 SE Woodstock Blvd
Portland, OR 97206-6271 - Phone
- (503) 379-0562
- NPI assigned
- Sep 5, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | D12113 | OR | Primary |
Addresses
Primary practice location
4419 SE Woodstock Blvd
Portland, OR 97206-6271
Mailing address
4419 SE Woodstock Blvd
Portland, OR 97206-6271
Phone (909) 680-0846
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D12113 | OR | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737504000000",
"number": "1801517255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4419 SE WOODSTOCK BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972066271",
"telephone_number": "909-680-0846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4419 SE WOODSTOCK BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972066271",
"telephone_number": "503-379-0562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASUDA",
"first_name": "GARRETT",
"credential": "DDS, MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-05",
"last_updated": "2025-01-22",
"certification_date": "2025-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "OR",
"license": "D12113",
"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 Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.