PEDIATRIC DENTAL GROUP NPI 1972770097

NPI Information

NPI: 1972770097
Provider Name: PEDIATRIC DENTAL GROUP
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
5415 SW WESTGATE DR
SUITE 207
PORTLAND, OR
ZIP 97221
Phone: (503) 292-9274
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PEDIATRIC DENTAL GROUP is a pediatric dentistry dentist in Portland, OR. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. PEDIATRIC DENTAL GROUP NPI is 1972770097. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5415 SW WESTGATE DR
SUITE 207
PORTLAND, OR
ZIP 97221-409
Phone: (503) 292-9274
Fax: (503) 292-2337

The provider's authorized official is David J Cavano .
The authorized official title is Dentist and has the following contact phone number (503) 292-9274.

The enumeration date for this NPI number is 5/8/2008 and was last updated on 5/8/2008.

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	1223P0221X	Dentist	Pediatric Dentistry	D7977	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: 4/28/2024

NPI Synchronization or Removal

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