DR. ROBERT W. SOUTHWORTH (NPI# 1861612889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861612889 |
| Entity Type | Individual |
| Full Name | DR. ROBERT W. SOUTHWORTH |
| Credential | D. M. D. |
| Practice Address |
1822 Ne 33rd Ave Portland OR 97212-5112 |
| Practice Telephone | 5032490770 |
| Practice Fax Number | 5032801118 |
| Mailing Telephone | 5032490770 |
| Mailing Fax Number | 5032801118 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
5220 | OR | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154726826 | Robert Hand Southworth | Registered Nurse | 8905 E Tano Pl, Tucson, AZ 85749-9154 | 2014-10-23 |
| 1982998381 | Robert Hurd Southworth | Dentist | 609 Jackson St, Wausau, WI 54403-5550 | 2011-06-02 |
| Street Address |
1822 NE 33RD AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97212-5112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396904041 | Krysten Ann Clist | Dental Hygienist | 1822 Ne 33rd Ave, Portland, OR 97212-5112 | 2008-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285191361 | Beliving Counseling and Consulting | Counselor | 311 Ne Russell Street, #211, Portland, OR 97212 | 2019-02-26 |
| 1497223051 | Shira Dennis | Behavioral Analyst | 3424 Ne Tillamook St., Portland, OR 97212 | 2018-11-12 |
| 1659890317 | Cidnee Potter | Doula | 2915 Ne Mlk Jr Blvd, Portland, OR 97212 | 2017-09-14 |
| 1588194187 | Ann M Staple | Counselor | 2905 Ne Tillamook St, Portland, OR 97212 | 2017-06-15 |
| 1780129502 | Noelle Denise King | Naturopath | 2540 Ne Martin Luther King Jr Blvd Femelle Integrative, Suite A, Portland, OR 97212 | 2017-01-03 |
| 1285085100 | Jessica Battin | Massage Therapist | 2310 Ne 8th Ave #2, Portland, OR 97212 | 2016-06-22 |
| 1316311830 | Dr Elise Schroeder | Clinic/Center | 3531 Ne 15th Ave Suite A, Portland, OR 97212 | 2015-11-20 |
| 1467820738 | Ayanna Askari | Counselor | 3655 N E Grand Ave, Portland, OR 97212 | 2015-09-03 |
| 1053797167 | Iliana Henriquez | Social Worker | 3500 Ne Martin Luther King Blvd Suite 200, Portland, OR 97212 | 2015-07-31 |
| 1417346834 | Emily Mcdonough Comerford | Case Manager/Care Coordinator | 1823 Ne 8th Avenue, Kinship House, Portland, OR 97212 | 2015-01-22 |
| Find all providers in zip 97212 | ||||
| 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.