PERIODONTAL ASSOCIATES LLC NPI 1669710331

NPI Information

  • NPI: 1669710331
  • Provider Name: PERIODONTAL ASSOCIATES, LLC
  • Classification: Dentist - 1223P0300X
  • Specialization: Periodontics
  • Entity Type: Organization
  • Address: 18753 SW MARTINAZZI AVE
    TUALATIN, OR
    ZIP 97062
  • Phone: (503) 620-2807

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NPI Details

PERIODONTAL ASSOCIATES, LLC is a periodontics dentist in Tualatin, OR. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. PERIODONTAL ASSOCIATES, LLC NPI is 1669710331. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

18753 SW MARTINAZZI AVE
TUALATIN, OR
ZIP 97062-808
Phone: (503) 620-2807
Fax: (503) 968-5419

The provider's authorized official is Bradley Mcallister .
The authorized official title is Partner and has the following contact phone number (503) 620-2807.

The enumeration date for this NPI number is 1/30/2013 and was last updated on 8/24/2015.

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
11223P0300XDentistPeriodonticsD6900OREGONYes

What is NPI?

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This page was last updated on: 11/21/2025

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