PERIO AESTHETICS & IMPLANTOLOGY (NPI# 1174646129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174646129 |
| Entity Type | Organization |
| Organization Name | PERIO AESTHETICS & IMPLANTOLOGY |
| Practice Address |
15455 Nw Greenbrier Pkwy Suite 235 Beaverton OR 97006-7374 |
| Practice Telephone | 5036453333 |
| Practice Fax Number | 5036451760 |
| Mailing Telephone | 5036453333 |
| Mailing Fax Number | 5036451760 |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ALEXIS K MCCLAIN (FRONT OFFICE COORDINATOR) |
| Authorized Official Telephone | 5036453333 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
D8051 | OR | Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PERIO AESTHETICS & IMPLANTOLOGY, LLC | 15455 Nw Greenbrier Parkway Ste 235, Beaverton, OR 97006 |
| Street Address |
15455 NW GREENBRIER PKWY SUITE 235 |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97006-7374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235131624 | Dean A Moshofsky | Pediatrics | 15455 Nw Greenbrier Pkwy, Ste 111, Beaverton, OR 97006-7374 | 2005-08-15 |
| 1245771369 | Body & Face LLC | Massage Therapist | 15455 Nw Greenbrier Pkwy, Suite 120, Beaverton, OR 97006-7374 | 2017-03-09 |
| 1992243034 | Source Health Center | Chiropractor | 15455 Nw Greenbrier Pkwy, Suite #150, Beaverton, OR 97006-7374 | 2017-02-09 |
| 1376952275 | Novam-nutrition LLC | Non-Pharmacy Dispensing Site | 15455 Nw Greenbrier Pkwy, Suite #100, Beaverton, OR 97006-7374 | 2014-08-05 |
| 1164799813 | Rebecca Berzow | Naturopath | 15455 Nw Greenbrier Pkwy, Suite 100, Beaverton, OR 97006-7374 | 2011-11-23 |
| 1508142894 | Sharon Suzanne Carter | Social Worker | 15455 Nw Greenbrier Pkwy, Suite 240, Beaverton, OR 97006-7374 | 2011-10-31 |
| 1053610527 | Sherry L Sweeney | Nurse Practitioner | 15455 Nw Greenbrier Pkwy, Suite 111, Beaverton, OR 97006-7374 | 2011-03-22 |
| 1740588185 | Columbia Care LLC | In Home Supportive Care | 15455 Nw Greenbrier Pkwy, Ste 205, Beaverton, OR 97006-7374 | 2011-03-09 |
| 1417151382 | Sara Murdick | Pediatrics | 15455 Nw Greenbrier Pkwy, Ste 111, Beaverton, OR 97006-7374 | 2007-06-13 |
| 1881714061 | 2 Roads Crossing Healthcare, PC | Psychologist | 15455 Nw Greenbrier Pkwy, Suite 240, Beaverton, OR 97006-8116 | 2007-03-30 |
| Find all providers in the same location | ||||
| 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 | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376944314 | Mikhail Garibov | Dentist | 17895 Nw Evergreen Pkwy Ste 130, Beaverton, OR 97006-7402 | 2014-09-09 |
| 1750300687 | Samuel Gottlieb | Dentist | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97006-4443 | 2006-07-19 |
| 1336419787 | Beaverton Periodontics | Dentist | 14500 Sw Murray Scholls Dr, Suite #101, Beaverton, OR 97007-9277 | 2012-01-03 |
| 1174668156 | Dennis Gene Perala | Dentist | 8070 Sw Hall Blvd, #200, Beaverton, OR 97008-6419 | 2007-02-20 |
| 1700846896 | Duy Anh Tran | Dentist | 14780 Sw Osprey Dr, Suite 240 A, Beaverton, OR 97007-8028 | 2006-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871026062 | Leila Soltani | Dentist | 430 Sw 13th Ave Apt 2010, Portland, OR 97205 | 2017-04-05 |
| 1427504828 | Shashank Joshi | Dentist | 1739 W Harvard Ave, Roseburg, OR 97471-2716 | 2016-08-26 |
| 1982056479 | Mari Heslinga | Dentist | 21332 Sw Langer Farms Pkwy Ste 126, Sherwood, OR 97140 | 2016-07-07 |
| 1548671340 | Polaris Dental Specialists | Dentist | 620 12th Street Se, Salem, OR 97301 | 2014-05-14 |
| 1295159986 | Andrew N Dow Dmd PC | Dentist | 4750 Village Plaza Loop Ste 102, Eugene, OR 97401-6601 | 2014-02-14 |
| 1043581465 | Riverplace Periodontics PC | Dentist | 2636 Se Harrison Street, Suite A, Milwaukie, OR 97222 | 2012-01-17 |
| 1730472986 | Wilson D Lee | Dentist | 315 Nw Lost Springs Ter, #401, Portland, OR 97229-6444 | 2011-05-20 |
| 1184954422 | Kamran Haghighat Bds Ms PC | Dentist | 833 Sw 11th Ave Ste 1020, Portland, OR 97205-2124 | 2010-01-08 |
| 1467683276 | Sunny L Drake | Dentist | 2235 Mission St Se Ste 250, Salem, OR 97302-1294 | 2009-07-29 |
| 1255574778 | Steven David Apfelbaum | Dentist | 1201 Nw Wall St., Suite 102, Bend, OR 97701 | 2009-04-14 |
| Find all providers with the same taxonomy | ||||
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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.