Advantage Dental Group, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ADVANTAGE DENTAL GROUP, PC

Doing business as

Advantage Dental Oral Health Center

Practice address

63140 Britta St Ste D104
Bend, OR 97703-5738

Phone

(888) 468-0022

NPI assigned

Aug 28, 2015

Last updated

Jan 3, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sharon Edmondson

Title

Manager, Licensing & Credentialing

Phone

(629) 999-5014

Specialties & licenses 1

Addresses

Other names 1

• Advantage Dental Oral Health Center Doing business as

Tax ID family

Advantage Dental Group PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Advantage Dental Group, PC

  dba Advantage Dental Oral Health Center

  • General Practice Dentistry
  • Bandon, OR
  • NPI 1447812813
  NPD tax ID
• Advantage Dental Group, PC

  dba Advantage Dental Oral Health Center

  • General Practice Dentistry
  • Boardman, OR
  • NPI 1831741958
  NPD tax ID

Locations

Practitioners 39

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.

• Kayla Allen Breyer, DMD

  • General Practice Dentistry
  • Salem, OR
  • NPI 1093594863
  NPD
• Hessam Rikhtehgar Berenji, LD

  • Denturist
  • Hillsboro, OR
  • NPI 1699524629
  NPD
• Emilia C Adam, PEDIATRIC DENTIST

  • Pediatric Dentistry
  • Portland, OR
  • NPI 1679727929
  NPD (past)
• Hasanain Al-Humairi, RDH

  • Dental Hygienist
  • Portland, OR
  • NPI 1851771588
  NPD (past)
• Wasan M Alabbasi

  • Dental Hygienist
  • Hillsboro, OR
  • NPI 1437955671
  NPD (past)
• Zeineb H Alturky, RDH

  • Dental Hygienist
  • Portland, OR
  • NPI 1730086042
  NPD (past)
• Tariq Barghouti, DDS

  • General Practice Dentistry
  • Hillsboro, OR
  • NPI 1801826995
  NPD (past)
• Lyudmila Batazhan, RDH

  • Dental Hygienist
  • Clackamas, OR
  • NPI 1770988305
  NPD (past)
• Lyubov Bazyuk

  • Dental Hygienist
  • Portland, OR
  • NPI 1104311414
  NPD (past)
• Melissa De Mattos, DDS

  • General Practice Dentistry
  • Portland, OR
  • NPI 1669126744
  NPD (past)
• Tembre Eliza Delong, DMD

  • Endodontics
  • Oregon City, OR
  • NPI 1861017824

  General Practice

  NPD (past)
• Phuong Doan, DMD

  • General Practice Dentistry
  • Portland, OR
  • NPI 1306883285
  NPD (past)

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672704000000",
    "number": "1972970671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63140 BRITTA ST STE D104",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977035738",
            "telephone_number": "888-468-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63140 BRITTA ST STE D104",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977035738",
            "telephone_number": "888-468-0022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10535 NE Glisan St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972204077",
            "country_code": "US",
            "telephone_number": "503-444-2824",
            "fax_number": "503-444-2823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 SE 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971234019",
            "country_code": "US",
            "telephone_number": "503-213-1257",
            "fax_number": "503-213-1258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13831 NW Cornell Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972295465",
            "country_code": "US",
            "telephone_number": "503-614-9999",
            "fax_number": "503-439-1299",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5880 NE Cornell Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971249075",
            "country_code": "US",
            "telephone_number": "503-615-8600",
            "fax_number": "503-681-8691",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7107 S MacAdam Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972193075",
            "country_code": "US",
            "telephone_number": "503-293-5454",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 N Roosevelt Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Seaside",
            "state": "OR",
            "postal_code": "971384603",
            "country_code": "US",
            "telephone_number": "503-738-2036",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3514 NE Broadway St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972321821",
            "country_code": "US",
            "telephone_number": "503-284-1602",
            "fax_number": "503-284-1587",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13831 NW Cornell Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972295465",
            "country_code": "US",
            "telephone_number": "503-718-3762",
            "fax_number": "503-718-3766",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13023 SE 84th Ave",
            "address_purpose": "LOCATION",
            "city": "Clackamas",
            "state": "OR",
            "postal_code": "970159798",
            "country_code": "US",
            "telephone_number": "503-353-9992",
            "fax_number": "503-513-0747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANTAGE DENTAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-28",
        "last_updated": "2023-01-03",
        "certification_date": "2021-10-25",
        "status": "A",
        "authorized_official_last_name": "EDMONDSON",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "MANAGER, LICENSING & CREDENTIALING",
        "authorized_official_telephone_number": "629-999-5014"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advantage Dental Oral Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advantage Dental Oral Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Bend, OR
• Providers in Bend, 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 Jan 3, 2023; 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.