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HUMBLE RICHMOND & RUSSELL ORAL & MAXILLOFACIAL SURGERY LLC NPI 1902100316


NPI Information

NPI: 1902100316
Provider Name: HUMBLE RICHMOND & RUSSELL ORAL & MAXILLOFACIAL SURGERY, LLC
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
1201 SE 223RD AVE
SUITE 180
GRESHAM, OR
ZIP 97030
Phone: (503) 667-1431
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HUMBLE RICHMOND & RUSSELL ORAL & MAXILLOFACIAL SURGERY, LLC is an oral and maxillofacial surgery dentist in Gresham, OR. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. HUMBLE RICHMOND & RUSSELL ORAL & MAXILLOFACIAL SURGERY, LLC NPI is 1902100316. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1201 SE 223RD AVE
SUITE 180
GRESHAM, OR
ZIP 97030-574
Phone: (503) 667-1431
Fax: (503) 492-0880

The provider's authorized official is Denise Olson .
The authorized official title is Bookkeeper and has the following contact phone number (503) 667-1431.

The enumeration date for this NPI number is 12/28/2010 and was last updated on 12/28/2010.


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
11223S0112XDentistOral and Maxillofacial SurgeryD7053OREGONNo
21223S0112XDentistOral and Maxillofacial SurgeryD9295OREGONNo
31223S0112XDentistOral and Maxillofacial SurgeryD6660OREGONYes

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

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