Active NPI
Theresa Calcagno, DMD
- Dentist
- Portland, OR
National Provider Identifier
1912906793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6158
- Practice address
- 511 SW 10TH Ave.
Suite 704
Portland, OR 97205 - Phone
- (503) 227-2883
- Fax
- (503) 226-5627
- NPI assigned
- Jul 14, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6158 | OR | Primary |
Addresses
Primary practice location
511 SW 10TH Ave.
Suite 704
Portland, OR 97205
Mailing address
511 SW 10TH Ave.
Suite 704
Portland, OR 97205
Phone (503) 227-2883
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6158 | OR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John Bajusack DMD, PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1912906793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 SW 10TH AVE.",
"address_2": "SUITE 704",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97205",
"telephone_number": "503-227-2883",
"fax_number": "503-226-5627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 SW 10TH AVE.",
"address_2": "SUITE 704",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97205",
"telephone_number": "503-227-2883",
"fax_number": "503-226-5627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALCAGNO",
"first_name": "THERESA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "6158",
"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 Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.