NPI 1447515747 · live from the CMS NPI Registry
Beaverton Orthodontics, PC
Dentist, Orthodontics and Dentofacial Orthopedics in Beaverton, OR. National Provider Identifier 1447515747, active.
NPI record
| NPI | 1447515747 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 14795 Sw Murray Scholls Dr, Ste 119, Beaverton, OR 97007 |
| Practice phone | 503-524-0524 |
| Mailing address | Po Box 1891, Lake Oswego, OR 97035 |
| Enumerated | July 12, 2012 |
| Last updated | July 12, 2012 |
| Authorized official | Steven Black, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | D6736 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.