DR. MIRA KHAROTI DELLA CROCE (NPI# 1134439144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134439144 |
| Entity Type | Individual |
| Full Name | DR. MIRA KHAROTI DELLA CROCE |
| Other Name | MIRA KHAROTI |
| Credential | D.M.D. |
| Practice Address |
1791 Nw 173rd Ave Ste 110 Beaverton OR 97006-5630 |
| Practice Telephone | 5033725527 |
| Mailing Telephone | 5033725527 |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2019-04-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | D10523 | OR | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DS038260 | PA | Dental Providers |
| Street Address |
1791 NW 173RD AVE STE 110 |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97006-5630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326518119 | Magnolia Family Dentistry, LLC | Clinic/Center | 1791 Nw 173rd Ave Ste 110, Beaverton, OR 97006-5630 | 2018-12-05 |
| 1295168086 | Teresa Williams | Dental Hygienist | 1791 Nw 173rd Ave Ste 110, Beaverton, OR 97006-5630 | 2013-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184238727 | Hayden Alexander Meriwether | Dentist | 17895 Ne Evergreen Pkwy, #100, Beaverton, OR 97006 | 2020-09-01 |
| 1336781202 | Courtney Rae Murata | Behavior Technician | 337 Nw 215th Terrace, Apt, 106, Hillsboro, OR 97006 | 2019-10-11 |
| 1992355986 | Pamela J. Viado | Technician | 1220 Nw Weybridge Way, Beaverton, OR 97006 | 2019-09-12 |
| 1477115384 | One Change Group | Community/Behavioral Health | 2499 Nw 206th Ave, Apt A233, Hillsboro, OR 97006 | 2019-07-01 |
| 1649731332 | Regina C. Rizo | Social Worker | 1925 Amberglen Parkway, #3a-131, Hillsboro, OR 97006 | 2019-03-26 |
| 1043731912 | Elizabeth A Cintron | Occupational Therapy Assistant | 1189 Ne 89th Ave Apt 305, Hillsboro, OR 97006 | 2017-06-30 |
| 1265979173 | Lindsay Jensen | Massage Therapist | 15220 Nw Greenbrier Pkwy Ste 260, Beaverton, OR 97006 | 2017-01-30 |
| 1851835722 | Changepoint, Inc | Clinic/Center | 1700 Nw 167th Place, Suite 240, Beaverton, OR 97006 | 2016-12-13 |
| 1689126302 | Occupational Health Centers of The Southwest, P.a. (tx) | Clinic/Center | 2225 Nw Towncenter Drive, Beaverton, OR 97006 | 2016-10-28 |
| 1558717413 | Dillon Duvall | Physical Therapist | 16895 Nw Cornell Rd, #110, Beaverton, OR 97006 | 2016-05-10 |
| Find all providers in zip 97006 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486438 | Jane Jeeyoon Kim | Dentist | 14425 Sw Allen Blvd # 1, Beaverton, OR 97005-4402 | 2020-10-30 |
| 1124631650 | Sugandha Gupta | Dentist | 2561 Nw 167th Ave, Beaverton, OR 97006-7643 | 2020-08-25 |
| 1508484205 | Dental Professionals of Oregon, P.C. | Dentist | 12850 Sw Canyon Rd Ste A, Beaverton, OR 97005-2166 | 2020-07-09 |
| 1568021871 | Evan Whisenant | Dentist | 13730 Sw Weir Rd, Beaverton, OR 97008-8063 | 2019-06-10 |
| 1528562535 | Caring Smiles Dental, LLC | Dentist | 15000 Sw Barrows Rd Ste 204, Beaverton, OR 97007-8778 | 2018-03-23 |
| 1043724917 | Cedar Hills Modern Dentistry, PC | Dentist | 2905 Sw Cedar Hills Blvd Ste 120, Beaverton, OR 97005-1342 | 2017-11-29 |
| 1124543640 | Patrick Ching Hsiang Chuang | Dentist | 12450 Sw Pioneer Ln, Ste B, Beaverton, OR 97008-8377 | 2017-08-04 |
| 1992242093 | Kaiser Foundation Health Plan of The Northwest | Dentist | 12450 Sw Walker Rd, Beaverton, OR 97005-1401 | 2017-01-26 |
| 1730633801 | Kedy Shen | Dentist | 15000 Sw Barrows Rd, Beaverton, OR 97007-8712 | 2016-08-06 |
| 1407217615 | Anita Trieu | Dentist | 12075 Sw Allen Blvd, Beaverton, OR 97005-4787 | 2016-03-15 |
| Find all providers in BEAVERTON | ||||
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| 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.