NPIMap

Organization Active NPI

Zola Dental Raleigh Park LLC, Dr. Anthony Paventy DMD

Doing business as Cloud Nine Dental at Raleigh Park

  • Dental Clinic/Center
  • Portland, OR
National Provider Identifier
1891450185
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
ZOLA DENTAL RALEIGH PARK LLC, DR. ANTHONY PAVENTY DMD
Doing business as
Cloud Nine Dental at Raleigh Park
Practice address
8568 SW Apple Way
Portland, OR 97225-1772
Phone
(503) 292-6773
Fax
(503) 292-6773
NPI assigned
Nov 2, 2021
Last updated
Nov 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Authorized official

Name
Dr. Cristina Waterman, DDSNPI 1932400660
Title
Associate Dentist
Phone
(503) 292-6773

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

8568 SW Apple Way
Portland, OR 97225-1772

Mailing address

8568 SW Apple Way
Portland, OR 97225-1772
Phone (503) 292-6773

Other names 1

  • Cloud Nine Dental at Raleigh Park Doing business as

National Provider Directory

National Provider Directory

Locations

8568 SW Apple Way
Portland, OR 97225
Phone (503) 292-6773

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635811200000",
    "number": "1891450185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8568 SW APPLE WAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251772",
            "telephone_number": "503-292-6773",
            "fax_number": "503-292-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8568 SW APPLE WAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251772",
            "telephone_number": "503-292-6773",
            "fax_number": "503-292-6773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZOLA DENTAL RALEIGH PARK LLC, DR. ANTHONY PAVENTY DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-02",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A",
        "authorized_official_last_name": "WATERMAN",
        "authorized_official_first_name": "CRISTINA",
        "authorized_official_title_or_position": "ASSOCIATE DENTIST",
        "authorized_official_telephone_number": "503-292-6773",
        "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": "Cloud Nine Dental at Raleigh Park",
            "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 Nov 2, 2021; 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.