SAM SEOHO BAE


Address: 6464 Sw Borland Rd Ste D3, Tualatin, OR 97062
Phone: 5036925654

SAM SEOHO BAE (NPI# 1124381629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1124381629
Entity Type Individual
Full Name SAM SEOHO BAE
Credential M.D., D.D.S.
Practice Address 6464 Sw Borland Rd Ste D3
Tualatin
OR 97062
Mailing Address 6464 Sw Borland Rd Ste D3
Tualatin
OR 97062-8861
Practice Telephone 5036925654
Mailing Telephone 5036925654
Enumeration Date 2012-06-19
Last Update Date 2019-06-29
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 204E00000X Oral & Maxillofacial Surgery MD191912 OR Allopathic & Osteopathic Physicians
N 204E00000X Oral & Maxillofacial Surgery 33845 TX Allopathic & Osteopathic Physicians
N 204E00000X Oral & Maxillofacial Surgery R6146 TX Allopathic & Osteopathic Physicians
N 204E00000X Oral & Maxillofacial Surgery 4301109828 MI Allopathic & Osteopathic Physicians
N 204E00000X Oral & Maxillofacial Surgery 2901020742 MI Allopathic & Osteopathic Physicians

Office Location

Street Address 6464 SW BORLAND RD STE D3
City TUALATIN
State OR
Zip Code 97062

Providers in the same location

NPI Name Taxonomy Address Enumeration
1194280685 Daniel Petrisor Dmd Md LLC Dentist 6464 Sw Borland Rd Ste D3, Tualatin, OR 97062-8861 2019-02-08

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1467018739 Activeedge Tualatin, LLP Physical Therapist 19150 Sw 90th Avenue, Suite 200, West Linn, OR 97062 2019-05-13
1932607934 Naturalways Pediatrics Clinic/Center 18813 Sw Martiazzi Ave, Tualatin, OR 97062 2018-01-25
1831646280 Elizabeth Erin Tafesse Behavioral Analyst 18765 Sw Boones Ferry Rd Suite 100, Tualatin, OR 97062 2016-09-01
1962851311 Ana Mercedes Cerritos-sanchez Community Health Worker 19355 Sw 65th Ave Apt A5, Tualatin, OR 97062 2016-06-07
1952759318 William Luke Summers Counselor 18840 Southwest Boones Ferry Rd, Suite 208, Tualatin, OR 97062 2016-05-26
1730536913 Krystle Alligood Behavioral Analyst 18768 Sw Boones Ferry Road, Tualatin, OR 97062 2016-05-18
1760869739 Oregon City Medical Nw, Inc Clinic/Center 6464 Sw Borland Road #d-4, Tualatin, OR 97062 2015-04-29
1396148904 Tracy Filley Clinical Nurse Specialist 18840 Sw Boones Ferry Rd, Suite 208, Tualatin, OR 97062 2014-09-28
1043646474 Michelle Lords Registered Nurse 7668 Sw Mohawk Street, Tualatin, OR 97062 2013-09-17
1871930750 Sharon Ruth Frank Social Worker 7668 Sw Mohawk St., Aps Healthcare, Tualatin, OR 97062 2013-05-31
Find all providers in zip 97062

Taxonomy Information

Taxonomy Code 204E00000X
Grouping Allopathic & Osteopathic Physicians
Classification Oral & Maxillofacial Surgery

Taxonomy Definition

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.
Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1619242591 Willamette Valley Oral & Maxillofacial Surgery, Inc Oral & Maxillofacial Surgery 3996 Corredale Ct. S., Salem, OR 97302 2012-03-12
1568605731 Philip C Mann Oral & Maxillofacial Surgery 16455 Boones Ferry Rd Ste B, Lake Oswego, OR 97035-4367 2009-04-16
1821162595 Daniel J Olson Oral & Maxillofacial Surgery 2510 Nw Medical Park Drive, Roseburg, OR 97470 2006-11-17
1952329450 Timothy B Welch Oral & Maxillofacial Surgery 911 Country Club Rd Ste 100, Eugene, OR 97401-6045 2006-07-17
1346249281 Bryce Earl Potter Oral & Maxillofacial Surgery 1849 Nw Kearney St, Ste 300, Portland, OR 97209-1453 2005-07-20
1932611696 Philip C. Mann, Dds, Md, LLC Oral & Maxillofacial Surgery 16455 Boones Ferry Rd Ste B, Lake Oswego, OR 97035-4367 2017-11-02
1053864561 Karl Cuddy Oral & Maxillofacial Surgery 2801 N Gantenbein Ave, Portland, OR 97227-1623 2016-08-01
1104209386 Felix Wiyanto Sim Oral & Maxillofacial Surgery 1015 Nw 22nd Ave, Portland, OR 97210-3025 2015-07-07
1407109937 Providence Health & Services - Oregon Oral & Maxillofacial Surgery 4805 Ne Glisan St, Suite 6n50, Portland, OR 97213-2933 2012-10-22
1447525852 Brett A. Ueeck Dmd, Md, PC Oral & Maxillofacial Surgery 11786 Sw Barnes Rd Ste 110, Portland, OR 97225-5926 2012-03-19
Find all providers with the same taxonomy

Competitor

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City TUALATIN
Zip Code 97062

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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