Odonto Prosthetics

Primary specialty

Dental LaboratoryTaxonomy code 292200000X

License

686917 Issued in OR

Legal business name

ODONTO PROSTHETICS

Practice address

15 SE 22ND Avenue
Portland, OR 97214-1679

Phone

(503) 235-0774

NPI assigned

Dec 23, 2010

Organization subpart

No

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

Authorized official

Name

Peter Phan

Title

Owner

Phone

(503) 235-0774

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1293062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293062400000",
    "number": "1871897496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SE 22ND AVENUE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141679",
            "telephone_number": "503-235-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SE 22ND AVENUE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141679",
            "telephone_number": "503-235-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODONTO PROSTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-23",
        "last_updated": "2010-12-23",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-235-0774"
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": "OR",
            "license": "686917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Odinnma, LLC
• David R Odiorne, DC
• Christina Odoherty
• Christie Odom
• Thomas Odom
• Adeola Mary Oduyale
• Odyssey Science Innovations
• Jennifer Oechsner
• Mackenzie Oedell, CADC-R
• Emory Oeding, MA

• Dental Laboratory in Portland, OR
• Providers in Portland, OR by specialty
• Dental Laboratory in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2010; 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.