BEAVERTON ORAL SURGEONS (NPI# 1811121932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811121932 |
| Entity Type | Organization |
| Organization Name | BEAVERTON ORAL SURGEONS |
| Practice Address |
3925 Sw 153rd Dr Suite 100 Beaverton OR 97006-4166 |
| Mailing Address |
3925 Sw 153rd Drive Suite 100 Beaverton OR 97006-4168 |
| Practice Telephone | 5036467101 |
| Practice Fax Number | 5036467105 |
| Mailing Telephone | 5036467101 |
| Mailing Fax Number | 5036467105 |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2009-05-04 |
| Authorized Official Name | DR. PHILIP PATRICK GREEN (OWNER) |
| Authorized Official Telephone | 5036467101 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | BEAVERTON ORAL SURGEONS & DENTAL IMPLANT CENTER | 3925 Sw 153rd Dr Ste 100, Beaverton, OR 97003 |
| Oregon Corporations, Companies and Business Names | BEAVERTON ORAL SURGEONS EQUIPMENT, LLC | 3925 Sw 153rd Dr Ste 100, Beaverton, OR 97006 |
| Street Address |
3925 SW 153RD DR SUITE 100 |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97006-4166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972643963 | Anthony B. Bouneff | Dentist | 3925 Sw 153rd Dr, Suite #100, Beaverton, OR 97006-4166 | 2007-02-07 |
| 1518007582 | Philip P Green | Dentist | 3925 Sw 153rd Dr, Suite #100, Beaverton, OR 97006-4166 | 2007-02-07 |
| 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 | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275040404 | Oral and Facial Surgery | Clinic/Center | 6125 Ne Cornell Rd Ste 320, Hillsboro, OR 97124-5417 | 2018-01-09 |
| 1578957742 | Paul Buck Md, Dds, PC | Clinic/Center | 3332 N Lombard St, Suite C, Portland, OR 97217 | 2015-03-25 |
| 1811149297 | Dennis D. Johnson Dmd PC | Clinic/Center | 410 Lancaster Dr Ne Ste A, Salem, OR 97301-4794 | 2008-10-16 |
| 1285744573 | Todd A Schock PC Dmd Md | Clinic/Center | 1893 Ne Neff Rd, Bend, OR 97701-6112 | 2006-08-30 |
| 1386901734 | Mid-valley Oral, Maxillofacial & Implant Surgery | Clinic/Center | 1565 Liberty St Se, Salem, OR 97302-4345 | 2012-04-23 |
| 1316243660 | Gerald Alan Harper, Dds, PC | Clinic/Center | 2650 Suzanne Way, Suite 110, Eugene, OR 97408-7319 | 2011-02-03 |
| 1699908475 | Rogue Valley Oral & Maxillofacial Surgery, PC | Clinic/Center | 460 Murphy Road, Medford, OR 97504 | 2009-08-27 |
Please comment or provide details below to improve the information on BEAVERTON ORAL SURGEONS.
| 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.