Pediatric Dental Group in Portland - Pediatric Dentistry
Pediatric Dental Group - NPI 1972770097
Pediatric Dental Group is a Pediatric Dentistry in Portland, Oregon. Pediatric Dental Group practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Pediatric Dental Group is 1972770097. The last update date is 2008-05-08.
Pediatric Dental Group's current location address is 5415 Sw Westgate Dr, Portland, Oregon. You can contact this provider via phone number 5032929274 and fax number 5032922337. The mailing address for Pediatric Dental Group is 5415 Sw Westgate Dr, Portland, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Pediatric Dental Group |
|---|---|
| Address | 5415 Sw Westgate Dr, Portland, Oregon |
| Phone Number | 5032929274 |
| Fax Number | 5032922337 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DENTIST |
|---|---|
| Authorized Official Name | Cavano J David |
| Credentials | DDS |
| Telephone Number | 5032929274 |
NPI Number Detail
| NPI Number | 1972770097 |
|---|---|
| Provider Enumeration Date | 2008-05-08 |
| Last Updated Date | 2008-05-08 |
Provider Mailing Address Detail
| Address | 5415 Sw Westgate Dr |
|---|---|
| City | Portland |
| State | Oregon (OR) |
| Post Code | 972212409 |
| Phone Number | 5032929274 |
| Fax Number | 5032922337 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | D7977 |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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What is the unique identifier code issued to Pediatric Dental Group by the Centers for Medicare & Medicaid Services (CMS)?
The Pediatric Dental Group has been assigned the NPI (National Provider Identifier) 1972770097. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the Pediatric Dental Group located?
The Pediatric Dental Group is located at 5415 Sw Westgate Dr, Portland, OR 972212409.
What is the Pediatric Dental Group's area of specialization and corresponding taxonomy classification?
The Pediatric Dental Group's specialty field is Pediatric Dentistry, and it falls under the taxonomy code 1223P0221X, which categorizes healthcare providers based on their specialties.
On what date did the Pediatric Dental Group receive the assignment of its 1972770097 from the Centers for Medicare & Medicaid Services?
The Pediatric Dental Group was issued its 1972770097 by the Centers for Medicare & Medicaid Services on 2008-05-08.
As of what date was the information regarding Pediatric Dental Group, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Pediatric Dental Group, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2008-05-08.