NPI 1578040374 · live from the CMS NPI Registry
Tylor Daniel Brekke, DMD, MS
Dentist, Orthodontics and Dentofacial Orthopedics in Hillsboro, OR. National Provider Identifier 1578040374, active.
NPI record
| NPI | 1578040374 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 536 Se Oak St, Hillsboro, OR 97123 |
| Practice phone | 503-648-7775 |
| Mailing address | 2730 Sw Moody Ave, Sd-Ortho, Portland, OR 97201 |
| Enumerated | July 24, 2018 |
| Last updated | April 6, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | — (OR) |
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | D11229 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.