Cyrus Berger Javadi, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9114 Issued in OR

Practice address

1010 Main Ave
Tillamook, OR 97141-3818

Phone

(503) 842-7788

NPI assigned

Jul 1, 2008

Last updated

Oct 6, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dentalcare LLC

  • Dental Clinic/Center
  • Tillamook, OR
  • NPI 1316544935
  NPD Authorized official
• Sandcreek Dental LLC

  • Dental Clinic/Center
  • Tillamook, OR
  • NPI 1952669657
  NPD (past) Authorized official
• Tiffani a. Long DDS

  dba Farmington Dental Center

  • Dental Clinic/Center
  • Tillamook, OR
  • NPI 1962825117
  NPD (past)

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1811159759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 MAIN AVE",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971413819",
            "telephone_number": "503-842-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 MAIN AVE",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971413818",
            "telephone_number": "503-842-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVADI",
        "first_name": "CYRUS",
        "middle_name": "BERGER",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-01",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9114",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "24530",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Michelle Inforzato, M.D.
• Anna Elizabeth Jackson, LMT
• Jonathan Mark Jackson, DPT
• Rodney Gilkey Jackson, DC
• Brandy Jacob
• Christopher Don Jenck, OD
• Shelby Lynn Jenck, APRN, FNP-BC
• Erica Johnson, MPH, RD, LD
• Lee Michael Johnson, O.D.
• Donna Ann Jose, NP

• General Practice Dentistry in Tillamook, OR
• Providers in Tillamook, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.