Alberto J Ambard, DDS PC
Individual provider Active NPI Prosthodontics · Beaverton, OR
NPI 1861546780 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1861546780
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Prosthodontics 1223P0700X
- License
- D8274 (OR)
- Practice address
- 6900 SW 105TH Ave
Beaverton, OR 97008 - Phone
- (503) 643-6607
- Fax
- (503) 526-8915
- NPI assigned
- Jan 22, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 17, 2016 through Mar 17, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | D8274 | OR | Yes |
Addresses
Primary practice location
6900 SW 105TH Ave
Beaverton, OR 97008
Mailing address
6900 SW 105TH Ave
Beaverton, OR 97008
Phone (503) 643-6607
Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.