NPIMap

Organization Active NPI

Alaniz Family & Cosmetic Dentistry, PC

  • Dental Clinic/Center
  • Portland, OR
National Provider Identifier
1962930362
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D8603 Issued in OR
Legal business name
ALANIZ FAMILY & COSMETIC DENTISTRY, PC
Practice address
11701 SE Stark St
Portland, OR 97216-3759
Phone
(503) 262-1996
NPI assigned
May 30, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Abel Ahumada Alaniz, DMDNPI 1326150855
Title
President
Phone
(503) 262-1996

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D8603 OR Primary

Addresses

Primary practice location

11701 SE Stark St
Portland, OR 97216-3759

Mailing address

11701 SE Stark St
Portland, OR 97216-3759
Phone (503) 262-1996

Other identifiers 1

IdentifierTypeStateIssuer
500682004MedicaidOR

Other names 1

  • Alaniz Dental Other name

National Provider Directory

National Provider Directory

Locations

11701 SE Stark St
Portland, OR 97216
Phone (503) 262-1996

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": "1496102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1962930362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11701 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163759",
            "telephone_number": "503-262-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11701 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163759",
            "telephone_number": "503-262-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALANIZ FAMILY & COSMETIC DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "AHUMADA ALANIZ",
        "authorized_official_first_name": "ABEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-262-1996",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "D8603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500682004",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alaniz Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 21, 2022; 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.