DR. SAMUEL GOTTLIEB (NPI# 1750300687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750300687 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL GOTTLIEB |
| Credential | D.D.S. |
| Practice Address |
17675 Sw Tualatin Valley Hwy Beaverton OR 97006-4443 |
| Mailing Address |
12401 Shelby Ct Lake Oswego OR 97035-1102 |
| Practice Telephone | 5032593160 |
| Mailing Telephone | 5032450384 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
D7245 | OR | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255793865 | Samuel A Gottlieb | Student in an Organized Health Care Education/Training Program | 1800 Orleans St, Baltimore, MD 21287-0010 | 2016-03-23 |
| Street Address |
17675 SW TUALATIN VALLEY HWY |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97006-4443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487291043 | Jamie Lee Story | Dental Assistant | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97003-4443 | 2019-12-03 |
| 1700421583 | Francisca Yac Riscajche | Dental Assistant | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97003-4443 | 2019-11-15 |
| 1043751415 | Jesse Treanor | Dental Hygienist | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97003-4443 | 2017-03-17 |
| 1578015855 | Kaiser Foundation Health Plan of The Northwest | Dentist | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97003-4443 | 2016-11-02 |
| 1285180786 | Ann Archer | Dental Hygienist | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97003-4443 | 2016-08-25 |
| 1639541816 | Samantha Forst | Dental Assistant | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97003-4443 | 2015-10-27 |
| 1588036818 | Christina Swayne | Dental Assistant | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97003-4443 | 2015-10-26 |
| 1164855896 | Bridget Madeline Lambert | Dental Assistant | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97006-4443 | 2013-08-16 |
| 1770915084 | Krista V Brandt | Dental Assistant | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97006-4443 | 2013-08-08 |
| 1912248170 | Anna Koroteyev | Dental Hygienist | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97006-4443 | 2013-03-12 |
| 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 |
| 1336419787 | Beaverton Periodontics | Dentist | 14500 Sw Murray Scholls Dr, Suite #101, Beaverton, OR 97007-9277 | 2012-01-03 |
| 1174646129 | Perio Aesthetics & Implantology | Dentist | 15455 Nw Greenbrier Pkwy, Suite 235, Beaverton, OR 97006-7374 | 2007-04-06 |
| 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.