RIVERPLACE PERIODONTICS PC NPI 1043581465

NPI Information

  • NPI: 1043581465
  • Provider Name: RIVERPLACE PERIODONTICS PC
  • Classification: Dentist - 1223P0300X
  • Specialization: Periodontics
  • Entity Type: Organization
  • Doing Business As: RIVERPLACE PERIODONTICS
  • Address: 2636 SE HARRISON STREET
    SUITE A
    MILWAUKIE, OR
    ZIP 97222
  • Phone: (503) 654-5405

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NPI Details

RIVERPLACE PERIODONTICS PC is a periodontics dentist in Milwaukie, 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. RIVERPLACE PERIODONTICS PC NPI is 1043581465. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Riverplace Periodontics.

The provider's business location address is:

2636 SE HARRISON STREET
SUITE A
MILWAUKIE, OR
ZIP 97222
Phone: (503) 654-5405

The provider's authorized official is Duy Anh Tran .
The authorized official title is Periodontist and has the following contact phone number (503) 654-5405.

The enumeration date for this NPI number is 1/17/2012 and was last updated on 5/4/2015.

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
11223P0300XDentistPeriodonticsD7360OREGONYes

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This page was last updated on: 3/30/2025

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