Individual provider Active NPI

Thomas L Galbraith, DDS

  • Dentist
  • Portland, OR
National Provider Identifier
1992087753
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D8940 Issued in OR
Practice address
2730 SW Moody Avenue
Portland, OR 97201-5042
Phone
(503) 494-8867
Fax
(503) 494-2365
NPI assigned
Sep 16, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D8940 OR Primary

Addresses

Primary practice location

2730 SW Moody Avenue
Portland, OR 97201-5042

Mailing address

2730 SW Moody Avenue
Portland, OR 97201-5042
Phone (503) 494-8867

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D8940ORMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1316131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1992087753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 SW MOODY AVENUE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015042",
            "telephone_number": "503-494-8867",
            "fax_number": "503-494-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 SW MOODY AVENUE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015042",
            "telephone_number": "503-494-8867",
            "fax_number": "503-494-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALBRAITH",
        "first_name": "THOMAS",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-16",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D8940",
            "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 Jul 16, 2014; 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.