Individual provider Active NPI

Jared C Frisbie-Teel, DDS

  • Endodontics
  • Portland, OR
National Provider Identifier
1972768984
Registry record updated Sep 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D9327 Issued in OR
Practice address
10102 NE Glisan St
Portland, OR 97220-4456
Phone
(503) 257-5959
NPI assigned
Jul 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22D102363700 NJ
Endodontics 1223E0200X D9327 OR Primary

Addresses

Primary practice location

10102 NE Glisan St
Portland, OR 97220-4456

Mailing address

0720 SW Gaines St Unit 211
Portland, OR 97239-4650
Phone (646) 266-5427

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
22D102363700NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1216512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253232000000",
    "number": "1972768984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "0720 SW GAINES ST UNIT 211",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394650",
            "telephone_number": "646-266-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10102 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204456",
            "telephone_number": "503-257-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRISBIE-TEEL",
        "first_name": "JARED",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-20",
        "last_updated": "2009-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22D102363700",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OR",
            "license": "D9327",
            "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 Sep 18, 2009; 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.