Provider Type Icon

ICP TELEDENTISTRY NPI 1225771108


NPI Information

NPI: 1225771108
Provider Name: ICP TELEDENTISTRY
Classification: Dentist - 1223D0001X
Entity Type: Organization

Specialization: Dental Public Health

Address:
3439 SE HAWTHORNE BLVD # 906
PORTLAND, OR
ZIP 97214
Phone: (425) 494-0883
Get Directions

ICP TELEDENTISTRY is a dental public health dentist in Portland, OR. The provider is the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. ICP TELEDENTISTRY NPI is 1225771108. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3439 SE HAWTHORNE BLVD # 906
PORTLAND, OR
ZIP 97214-048
Phone: (425) 494-0883

The provider's authorized official is Chandan Sharma .
The authorized official title is Hod and has the following contact phone number (425) 494-0883.

The enumeration date for this NPI number is 4/18/2022 and was last updated on 4/18/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1124Q00000XDental HygienistNo
2125J00000XDental TherapistNo
3126800000XDental AssistantNo
4261QD0000XClinic/CenterDentalNo
5261QS0112XClinic/CenterOral and Maxillofacial SurgeryNo
61223D0001XDentistDental Public HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1006880293OTHERLOUISIANADL

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.