Mike Moody LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MIKE MOODY LLC

Doing business as

Uptown Family Dental

Practice address

2330 NW Flanders St Ste 204
Portland, OR 97210-3460

Phone

(503) 223-5040

NPI assigned

Sep 25, 2024

Last updated

Sep 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Thomas Moody, DDSNPI 1538739438

Title

Dentist

Phone

(503) 223-5040

Specialties & licenses 1

Addresses

Other names 1

• Uptown Family Dental Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Thomas Moody, DDS

  • General Practice Dentistry
  • Portland, OR
  • NPI 1538739438
  NPD Authorized official
• David B. Wiley, DMD

  • General Practice Dentistry
  • Portland, OR
  • NPI 1295954717
  NPD (past)

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

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1871310284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 NW FLANDERS ST STE 204",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103460",
            "telephone_number": "503-223-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 NW FLANDERS ST STE 204",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103460",
            "telephone_number": "503-223-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIKE MOODY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "503-223-5040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Uptown Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Camelia Mihart, AGACNP
• Paige Y Miho, DC
• Stephanie Mijo
• Mikalah Barem Nutrition LLC
• Steven Wayne Mikalson, LMT
• Mike Siegel LPC LLC
• Max Mikelson
• Clara Mikhaeil, PHARMD
• Mariya Mikhaylova
• Nataliya Sergeyevna Mikhaylova, MAC

• Dental Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.