Active NPI
Paul Erich Ortiz, DMD
- General Practice Dentistry
- Portland, OR
National Provider Identifier
1861563033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5566
- Practice address
- 2525 NE Broadway St Ste 200
Portland, OR 97232-1635 - Phone
- (503) 234-7870
- Fax
- (503) 236-9001
- NPI assigned
- Nov 10, 2006
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5566 | OR | Primary |
Addresses
Primary practice location
2525 NE Broadway St Ste 200
Portland, OR 97232-1635
Mailing address
2525 NE Broadway St Ste 200
Portland, OR 97232-1635
Phone (503) 234-7870
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 931165902 | Other | OR | TAX ID # |
| 5566 | Other | OR | LICENSE # |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5566 | OR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331683200000",
"number": "1861563033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 NE BROADWAY ST STE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321635",
"telephone_number": "503-234-7870",
"fax_number": "503-236-9001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 NE BROADWAY ST STE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321635",
"telephone_number": "503-234-7870",
"fax_number": "503-236-9001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ",
"first_name": "PAUL",
"middle_name": "ERICH",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-10",
"last_updated": "2012-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "5566",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID #",
"identifier": "931165902",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "5566",
"state": "OR"
}
],
"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 Mar 14, 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.