Pediatric Dental Group

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D7977 Issued in OR

Legal business name

PEDIATRIC DENTAL GROUP

Practice address

5415 SW Westgate Dr
Suite 207
Portland, OR 97221-2409

Phone

(503) 292-9274

Fax

(503) 292-2337

NPI assigned

May 8, 2008

Organization subpart

No

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

Authorized official

Name

Dr. David J Cavano, DDS

Title

Dentist

Phone

(503) 292-9274

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210204800000",
    "number": "1972770097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 SW WESTGATE DR",
            "address_2": "SUITE 207",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212409",
            "telephone_number": "503-292-9274",
            "fax_number": "503-292-2337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 SW WESTGATE DR",
            "address_2": "SUITE 207",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212409",
            "telephone_number": "503-292-9274",
            "fax_number": "503-292-2337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-08",
        "last_updated": "2008-05-08",
        "status": "A",
        "authorized_official_last_name": "CAVANO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "503-292-9274",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D7977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Pederson
• Tamara Pederson, PHD
• Timothy S Pederson, MD
• Pediatric Associates of the Northwest, PC
• Pediatric Cardiology Center of Oregon PC
• Pediatric Dentistry of Portland LLC
• Pediatric Dentistry, RC
• Pediatric Endocrinology of Portland, P.C.
• Pediatric Intensive Care Trauma Associates PC
• Pediatric Occupational Therapy Solutions, LLC

• Pediatric Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• Pediatric Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; 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.