NPIMap

Organization Active NPI

Gateway Dental Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Portland, OR
National Provider Identifier
1902287469
Registry record updated Jun 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
GATEWAY DENTAL SURGERY CENTER
Practice address
10535 NE Glisan St Ste 101
Portland, OR 97220-4095
Phone
(971) 229-8777
NPI assigned
Jun 10, 2015
Last updated
Jun 10, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL SERVICE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 10, 2015

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

Authorized official

Name
Kevin Boie
Title
Cfo
Phone
(360) 571-8181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary

Addresses

Primary practice location

10535 NE Glisan St Ste 101
Portland, OR 97220-4095

Mailing address

10535 NE Glisan St Ste 101
Portland, OR 97220-4095
Phone (971) 229-8777

National Provider Directory

National Provider Directory
Tax ID family
Gateway Dental Surgery Center2 organizations share this tax ID, including this one
Part of
Gateway Dental Surgery Center

Other organizations with this tax ID 1

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

Locations

10535 NE Glisan St
Ste 101
Portland, OR 97220
Phone (503) 258-1755

NPI Registry JSON

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

{
    "created_epoch": "1433894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1902287469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10535 NE GLISAN ST STE 101",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204095",
            "telephone_number": "971-229-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 NE GLISAN ST STE 101",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204095",
            "telephone_number": "971-229-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY DENTAL SURGERY CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL SERVICE, LLC",
        "enumeration_date": "2015-06-10",
        "last_updated": "2015-06-10",
        "status": "A",
        "authorized_official_last_name": "BOIE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "360-571-8181"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 10, 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.