LIFESMILE DENTAL GROUP NPI 1144416959

NPI Information

  • NPI: 1144416959
  • Provider Name: LIFESMILE DENTAL GROUP
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 13305 NW CORNELL RD
    SUITE A
    PORTLAND, OR
    ZIP 97229
  • Phone: (503) 644-5433

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NPI Details

LIFESMILE DENTAL GROUP is a general practice dentist in Portland, OR. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. LIFESMILE DENTAL GROUP NPI is 1144416959. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

13305 NW CORNELL RD
SUITE A
PORTLAND, OR
ZIP 97229-817
Phone: (503) 644-5433
Fax: (503) 633-5436

The provider's authorized official is Thomas Hicks .
The authorized official title is President and has the following contact phone number (503) 644-5433.

The enumeration date for this NPI number is 9/15/2007 and was last updated on 9/15/2007.

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
11223G0001XDentistGeneral PracticeD7362OREGONYes

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: 3/30/2025

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