PERIODONTAL ASSOCIATES LLC NPI 1669710331

NPI Information

NPI: 1669710331
Provider Name: PERIODONTAL ASSOCIATES, LLC
Classification: Dentist - 1223P0300X
Entity Type: Organization

Specialization: Periodontics

Address:
18753 SW MARTINAZZI AVE
TUALATIN, OR
ZIP 97062
Phone: (503) 620-2807
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PERIODONTAL ASSOCIATES, LLC is a periodontics dentist in Tualatin, OR. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. PERIODONTAL ASSOCIATES, LLC NPI is 1669710331. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

18753 SW MARTINAZZI AVE
TUALATIN, OR
ZIP 97062-808
Phone: (503) 620-2807
Fax: (503) 968-5419

The provider's authorized official is Bradley Mcallister .
The authorized official title is Partner and has the following contact phone number (503) 620-2807.

The enumeration date for this NPI number is 1/30/2013 and was last updated on 8/24/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0300X	Dentist	Periodontics	D6900	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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