EASTSIDE DENTAL CLINIC (NPI# 1689675167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689675167 |
| Entity Type | Organization |
| Organization Name | EASTSIDE DENTAL CLINIC |
| Practice Address |
1540 Sw 257th Ave Troutdale OR 97060-7412 |
| Mailing Address |
Po Box 700 Troutdale OR 97060-0700 |
| Practice Telephone | 5036652177 |
| Practice Fax Number | 5036667130 |
| Mailing Telephone | 5036652177 |
| Mailing Fax Number | 5036667130 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2020-08-22 |
| NPI Deactivation Date | 01/03/2007 |
| NPI Reactivation Date | 2007-01-30 |
| Authorized Official Name | DR. JOHN H KILIAN (DENTIST OWNER) |
| Authorized Official Telephone | 5036652177 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
========= | OR | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
OR | Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | EASTSIDE DENTAL CLINIC | 1540 Sw 257th Ave, Troutdale, OR 97060 |
| Street Address |
1540 SW 257TH AVE |
| City | TROUTDALE |
| State | OR |
| Zip Code | 97060-7412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245431162 | John Henry Kilian | Dentist | 1540 Sw 257th Ave, Troutdale, OR 97060-7412 | 2007-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861921124 | Kayla Michelle Stewart | Doula | 424 Se 19th St, Troutdale, OR 97060 | 2017-06-08 |
| 1467856955 | Meghan Ellen Revoir Bennett | Naturopath | 330 Se 3rd Street, Troutdale, OR 97060 | 2014-10-13 |
| 1699012310 | Scott C Williams | Pharmacist | 22855 N.e. Parklane, Wood Village, OR 97060 | 2013-01-15 |
| 1285888636 | Dan E. Cox | Counselor | 107 E. Historic Columbia River Hwy, Suite 207, Troutdale, OR 97060 | 2008-11-12 |
| 1356592596 | Emily J White | Pulmonary Function Technologist | 735 Sw 14th St, Troutdale, OR 97060 | 2008-10-07 |
| 1497905772 | Fred Meyer | Pharmacist | 22855 Ne Parklane, Wood Village, OR 97060 | 2008-09-24 |
| 1104072057 | Sharon Brennan | Nurse Practitioner | 2800 Sw 257th Avenue, Columbia View Family Health Center, Troutdale, OR 97060 | 2008-08-12 |
| 1902094386 | Steven Gary Cranford | Chiropractor | 1530 Sw 257th Dr., Troutdale, OR 97060 | 2007-10-10 |
| 1750581062 | Gresham-troutdale Family Medical Center | Non-Pharmacy Dispensing Site | 1700 Sw 27th Ave, Troutdale, OR 97060 | 2007-07-24 |
| 1710181755 | Valerie Kay Robertson | Specialist | 3703 Se 39th, Portland, OR 97060 | 2007-06-13 |
| Find all providers in zip 97060 | ||||
| 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 |
|---|---|---|---|---|
| 1518332923 | Troutdale Dental LLC | Dentist | 191 E Historic Columbia River Hwy, Troutdale, OR 97060-2076 | 2015-12-10 |
| 1285842385 | Modern Family Dental of Troutdale, LLC | Dentist | 25603 Se Stark St, Troutdale, OR 97060-3305 | 2007-05-21 |
| 1649323007 | Jianwei Jenny Lu | Dentist | 2513 Sw Cherry Park Rd, Troutdale, OR 97060-2931 | 2007-01-19 |
| 1659330041 | Douglas Clark Niemi | Dentist | 47 High Country Ln, Troutdale, VA 24378-2255 | 2006-03-22 |
| 1689103996 | Brian R Hale | Dentist | 191 E Historic Columbia River Hwy, Troutdale, OR 97060 | 2017-06-08 |
| 1245431162 | John Henry Kilian | Dentist | 1540 Sw 257th Ave, Troutdale, OR 97060-7412 | 2007-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486438 | Jane Jeeyoon Kim | Dentist | 14425 Sw Allen Blvd # 1, Beaverton, OR 97005-4402 | 2020-10-30 |
| 1780283556 | Ziyad Amir Kadir | Dentist | 300 Tatone St, Boardman, OR 97818-7900 | 2020-10-22 |
| 1295333912 | John Andrew Fawcett | Dentist | 214 Jersey St, Silverton, OR 97381-1627 | 2020-10-14 |
| 1629685920 | Alexandroff Dmd PC | Dentist | 1085 E Harbor Drive, Warrenton, OR 97146 | 2020-09-30 |
| 1760097034 | Hannah Glazunov | Dentist | 4970 S Landing Dr Unit 302, Portland, OR 97239-5900 | 2020-09-13 |
| 1235742198 | Geoffrey Houf | Dentist | 5880 Ne Cornell Rd Ste D, Hillsboro, OR 97124-9075 | 2020-08-28 |
| 1124631650 | Sugandha Gupta | Dentist | 2561 Nw 167th Ave, Beaverton, OR 97006-7643 | 2020-08-25 |
| 1609489137 | Open Door Dental Group PC | Dentist | 1710 E Pine St Ste A, Central Point, OR 97502-2811 | 2020-08-25 |
| 1720698566 | Travis Alcorn | Dentist | 2750 Kingwood St, Florence, OR 97439-9556 | 2020-08-06 |
| 1811506322 | Ruiwei Liang | Dentist | 547 Se 73rd Ave, Hillsboro, OR 97123-6199 | 2020-07-30 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on EASTSIDE DENTAL CLINIC.
| 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.