MARK E ENGELSTAD MD DDS NPI 1437102746

NPI Information

NPI: 1437102746
Provider Name: MARK E ENGELSTAD, MD, DDS
Classification: Oral & Maxillofacial Surgery - 204E00000X
Entity Type: Individual
PECOS Registration: Yes
Address: 3181 SW SAM JACKSON PARK RD
PORTLAND, OR
ZIP 97239
Phone: (503) 494-8914

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NPI Details

Mark E Engelstad, MD, DDS is an oral maxillofacial surgery in Portland, OR with 28 years of experience. The provider is oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. Mark E Engelstad, MD, DDS NPI is 1437102746. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
Graduation Year:1997

The provider's business location address is:

3181 SW SAM JACKSON PARK RD
PORTLAND, OR
ZIP 97239-011
Phone: (503) 494-8914
Fax: (503) 494-0294

The NPI 1437102746 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/18/2006 and was last updated on 10/10/2017.

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	1223S0112X	Dentist	Oral and Maxillofacial Surgery	DF0023	OREGON	No
2	204E00000X	Oral & Maxillofacial Surgery		MD153490	OREGON	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	H36750	MEDICARE UPIN
2	357147500	MEDICAID	MINNESOTA
3	850000038	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA

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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