PETER DOUGLAS DDS LLC NPI 1063234722

NPI Information

  • NPI: 1063234722
  • Provider Name: PETER DOUGLAS DDS LLC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 12011 SW 70TH AVE
    TIGARD, OR
    ZIP 97223
  • Phone: (503) 616-2024

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NPI Details

PETER DOUGLAS DDS LLC is a dental clinic center in Tigard, OR. PETER DOUGLAS DDS LLC NPI is 1063234722. The provider is registered as an organization entity type.

The provider's business location address is:

12011 SW 70TH AVE
TIGARD, OR
ZIP 97223-634
Phone: (503) 616-2024
Fax: (503) 616-2328

The provider's authorized official is Peter Douglas .
The authorized official title is Owner and has the following contact phone number (712) 560-6260.

The enumeration date for this NPI number is 10/24/2024 and was last updated on 10/24/2024.

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
1261QD0000XClinic/CenterDentalYes

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: 11/21/2025

NPI Synchronization or Removal

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