ROOTS DENTAL STARK LLC NPI 1063993749

NPI Information

NPI: 1063993749
Provider Name: ROOTS DENTAL STARK LLC

Doing Business As: ROOTS DENTAL

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
16338 SE STARK ST
PORTLAND, OR
ZIP 97233
Phone: (971) 294-1399
Get Directions

ROOTS DENTAL STARK LLC is a dental clinic center in Portland, OR. ROOTS DENTAL STARK LLC NPI is 1063993749. The provider is registered as an organization entity type.
The provider Is Doing Business As Roots Dental.

The provider's business location address is:

16338 SE STARK ST
PORTLAND, OR
ZIP 97233-958
Phone: (971) 294-1399

The provider's authorized official is Ryan Smith .
The authorized official title is Manager and has the following contact phone number (503) 912-2600.

The enumeration date for this NPI number is 8/22/2018 and was last updated on 9/20/2019.

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	261QD0000X	Clinic/Center	Dental	D9728	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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