Hollywood Family Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D8790 Issued in OR

Legal business name

HOLLYWOOD FAMILY DENTISTRY

Practice address

1735 NE 40TH Ave
Portland, OR 97212-5307

Phone

(503) 281-9612

NPI assigned

Oct 8, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy Kato

Title

Co-Owner

Phone

(503) 281-9612

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444262400000",
    "number": "1902277551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 NE 40TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972125307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 NE 40TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972125307",
            "telephone_number": "503-281-9612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLYWOOD FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-08",
        "last_updated": "2015-10-08",
        "status": "A",
        "authorized_official_last_name": "KATO",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "503-281-9612",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "D8790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Matthews, LCSW
• Holly Wigmore LLC
• Nicole Lee Holly, MD
• Jolea Hollyfield, RN
• Hollywood Children'S Dentistry
• Alaina Holm
• Carol Ann Holm, RN
• Diana Holm
• Janson L Holm, DPM
• Jeffrey T Holm

• 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 Oct 8, 2015; 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.