TD East Burnside GPS LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

TD EAST BURNSIDE GPS LLC

Doing business as

Timber Dental East Burnside

Practice address

1200 SE Sandy Blvd
Portland, OR 97214-1347

Phone

(503) 419-6499

NPI assigned

Mar 3, 2026

Organization subpart

No

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

Authorized official

Name

Dr. Matt Kathan

Title

Owner

Phone

(503) 419-6499

Specialties & licenses 1

Addresses

Other names 1

• Timber Dental East Burnside Doing business as

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

{
    "created_epoch": "1772496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776124800000",
    "number": "1922953298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141347",
            "telephone_number": "503-419-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TD EAST BURNSIDE GPS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-03",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A",
        "authorized_official_last_name": "KATHAN",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-419-6499",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Timber Dental East Burnside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Jordyn Kristine Teague
• Lisa Teague, LMT

• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.

Verify at the official NPI Registry.