NPIMap

Organization Active NPI

Portland Orthodontic Group

  • Dental Clinic/Center
  • Portland, OR
National Provider Identifier
1891212908
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D8844 Issued in OR
Legal business name
PORTLAND ORTHODONTIC GROUP
Practice address
742 NW Murray Blvd
Portland, OR 97229-5870
Phone
(503) 641-9100
NPI assigned
Aug 29, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Jennifer J Crowe, DDSNPI 1568796274
Title
Owner
Phone
(503) 641-9100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D8844 OR Primary

Addresses

Primary practice location

742 NW Murray Blvd
Portland, OR 97229-5870

Mailing address

742 NW Murray Blvd
Portland, OR 97229-5870
Phone (503) 641-9100

Other names 1

  • Yaillen Orthodontic Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Portland Orthodontic Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

742 NW Murray Blvd
Portland, OR 97229
Phone (503) 641-9100

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1891212908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 NW MURRAY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295870",
            "telephone_number": "503-641-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 NW MURRAY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295870",
            "telephone_number": "503-641-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND ORTHODONTIC GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CROWE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-641-9100",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "D8844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yaillen Orthodontic Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 21, 2022; 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.