MARVIN A PETERSON (NPI# 1841200946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841200946 |
| Entity Type | Individual |
| Full Name | MARVIN A PETERSON |
| Credential | DMD PC |
| Practice Address |
511 Sw 10th Ave Suite #707 Portland OR 97205-2732 |
| Practice Telephone | 5032234411 |
| Practice Fax Number | 5032229501 |
| Mailing Telephone | 5032234411 |
| Mailing Fax Number | 5032229501 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D5183 | OR | Dental Providers |
| Street Address |
511 SW 10TH AVE SUITE #707 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97205-2732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336146307 | Michael Charles Royse | Dentist | 511 Sw 10th Ave, Suite #810, Portland, OR 97205-2732 | 2005-07-05 |
| 1861049835 | Jennifer Larson | Counselor | 511 Sw 10th Ave, Portland, OR 97205-2732 | 2019-08-23 |
| 1720528235 | Jessica Lyn Collins | Massage Therapist | 511 Sw 10th Ave, Suite 610, Portland, OR 97205-2732 | 2017-03-02 |
| 1205378858 | Lilyan Charlotte Russel Smith-moore | Counselor | 511 Sw 10th Ave, #601, Portland, OR 97205-2732 | 2016-11-14 |
| 1184073496 | Julia Richfield | Specialist | 511 Sw 10th Ave, 1108, Portland, OR 97205-2732 | 2016-06-07 |
| 1821463050 | Fox Kids Dentistry & Orthodontics | Dentist | 511 Sw 10th Ave, Suite 810, Portland, OR 97205-2732 | 2015-12-14 |
| 1477927580 | Jacquelin Perry | Massage Therapist | 511 Sw 10th Ave, Ste 610, Portland, OR 97205-2732 | 2015-12-01 |
| 1912382078 | Dana Fox | Dentist | 511 Sw 10th Ave, Ste 810, Portland, OR 97205-2732 | 2015-07-29 |
| 1336524206 | Drew Barrios | Specialist | 511 Sw 10th Ave, Suite 1108, Portland, OR 97205-2732 | 2015-07-21 |
| 1891179875 | Jessica Mintie Kloenne | Dentist | 511 Sw 10th Ave, Ste 804, Portland, OR 97205-2732 | 2015-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871026062 | Leila Soltani | Dentist | 430 Sw 13th Ave Apt 2010, Portland, OR 97205 | 2017-04-05 |
| 1114374949 | Elizabeth Alire | Counselor | 1411 Sw Morrison St., Portland, OR 97205 | 2016-05-23 |
| 1508237462 | Pacific Psychology and Comprehensive Health Center | Community/Behavioral Health | 1411 Sw Morrison Ave, Suite 310, Portland, OR 97205 | 2015-10-16 |
| 1265803761 | Alana Branson | Naturopath | 1033 Sw Yamhill Street, Suite 403, Portland, OR 97205 | 2015-10-10 |
| 1720458011 | Kate Ohene | Counselor | 1411 Sw Morrison Street, Suite 310, Portland, OR 97205 | 2015-09-30 |
| 1285004671 | Christina Nannette Mendoza | Counselor | 1411 Sw Morriston Street, 310, Portland, OR 97205 | 2015-09-29 |
| 1083095947 | Patricia Burton | Registered Nurse | 1312 Sw Washinghton, Portland, OR 97205 | 2015-06-16 |
| 1649663071 | Huey Holistic | Clinic/Center | 1221 Sw Yamill, Suite 300, Portland, OR 97205 | 2015-03-10 |
| 1376952796 | Joan Kendall Ayala | Counselor | 610 Sw Alder St Ste 915, Portland, OR 97205 | 2014-08-11 |
| 1316356165 | Satheara Sin | Massage Therapist | 1033 Sw Yamhill St. #403, Portland, OR 97205 | 2014-08-06 |
| Find all providers in zip 97205 | ||||
| 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 |
|---|---|---|---|---|
| 1760097034 | Hannah Glazunov | Dentist | 4970 S Landing Dr Unit 302, Portland, OR 97239-5900 | 2020-09-13 |
| 1093345159 | Ashley Bennett Dds, LLC | Dentist | 5415 Sw Westgate Dr Ste 202, Portland, OR 97221-2429 | 2020-01-17 |
| 1841844354 | Carly K Christoferson | Dentist | 1616 Sw Sunset Blvd Ste A, Portland, OR 97239-2641 | 2019-08-01 |
| 1083279384 | Timber Dental Downtown LLC | Dentist | 310 Sw 4th Ave Ste 100, Portland, OR 97204-2345 | 2019-05-02 |
| 1780140715 | Timber Dental East Burnside | Dentist | 1200 Se Sandy Blvd, Portland, OR 97214-1347 | 2019-02-14 |
| 1548726581 | Timber Dental Bethany | Dentist | 15715 Nw Central Dr Ste 7-8, Portland, OR 97229-1267 | 2019-02-14 |
| 1124583208 | Portland Dental LLC | Dentist | 511 Sw 10th Ave Ste 1206, Portland, OR 97205-2713 | 2019-02-04 |
| 1245701465 | Jeffrey Levitt Brady | Dentist | 10060 E Burnside St, Portland, OR 97216-2334 | 2018-12-16 |
| 1780166918 | Daniel Alejandro Mesa | Dentist | 2038 Lloyd Ctr # H317, Portland, OR 97232-1309 | 2018-09-04 |
| 1093293375 | Trusha B Patel | Dentist | 3801 N Interstate Ave, Portland, OR 97227-1109 | 2018-07-30 |
| Find all providers in PORTLAND | ||||
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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.