SOROUSH AMALI (NPI# 1861846578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861846578 |
| Entity Type | Individual |
| Full Name | SOROUSH AMALI |
| Practice Address |
7201 N Interstate Ave Portland OR 97217-5523 |
| Mailing Address |
2730 Sw Moody Ave Portland OR 97201-5042 |
| Practice Telephone | 5032866868 |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2020-11-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D10530 | OR | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2730 Sw Moody Ave, Portland, OR 972015042 | 5035447573 |
| Street Address |
7201 N INTERSTATE AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97217-5523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831113646 | David Russell Hill | Dentist | 7201 N Interstate Ave, Portland, OR 97217-5523 | 2006-07-26 |
| 1336703198 | Vanessa Joan Grant | Dental Assistant | 7201 N Interstate Ave, Portland, OR 97217-5523 | 2019-04-26 |
| 1083102248 | Antonina Kutsar | Dental Assistant | 7201 N Interstate Ave, Portland, OR 97217-5523 | 2018-04-24 |
| 1245728427 | Kerri Logue | Dental Assistant | 7201 N Interstate Ave, Portland, OR 97217-5523 | 2018-04-24 |
| 1881146165 | Kaiser Foundation Health Plan of The Northwest | Dentist | 7201 N Interstate Ave, Portland, OR 97217-5523 | 2016-11-02 |
| 1194172239 | Cindy Brooke Firman | Dietitian, Registered | 7201 N Interstate Ave, Portland, OR 97217-5523 | 2016-05-18 |
| 1699154302 | Nancy Graham | Dietitian, Registered | 7201 N Interstate Ave, Portland, OR 97217-5523 | 2015-05-27 |
| 1003206236 | Melissa Dawn Hill | Counselor | 7201 N Interstate Ave, Portland, OR 97217-5523 | 2015-01-26 |
| 1831506815 | Robert Wilson | Dietetic Technician, Registered | 7201 N Interstate Ave, Portland, OR 97217-5523 | 2014-07-22 |
| 1053669838 | Katarzyna Teegarden | Dental Hygienist | 7201 N Interstate Ave, Portland, OR 97217-5523 | 2012-08-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326531666 | Working Class Medicine LLC | Clinic/Center | 2133 N. Willis Blvd, Studio D, Portland, OR 97217 | 2018-06-12 |
| 1235643602 | Autism Outreach of Oregon | Occupational Therapist | 10350 N Vancouver Way #1043, Portland, OR 97217 | 2017-11-21 |
| 1689183717 | Kai-uwe H. Hahn Dmd Dba Edelweiss Dental | Clinic/Center | 3503 N Lombard Street, Portland, OR 97217 | 2017-09-20 |
| 1407308125 | Occupational Health Centers of The Southwest, P.a. (tx) | Clinic/Center | 3449 N Anchor Street, Ste 300a, Portland, OR 97217 | 2016-10-28 |
| 1750740577 | Sheila Amoo | Adult Companion | 236 N Killingworth St. Apt.b104, Portland, OR 97217 | 2016-02-22 |
| 1801282199 | Justine Osborn | Specialist | 4310 N. Interstate Ave, Portland, OR 97217 | 2015-04-13 |
| 1578957742 | Paul Buck Md, Dds, PC | Clinic/Center | 3332 N Lombard St, Suite C, Portland, OR 97217 | 2015-03-25 |
| 1295158186 | Rebecca Bulleri | Massage Therapist | 5416 N. Maryland Ave, Portland, OR 97217 | 2014-01-28 |
| 1659793107 | Shellmire Unlimited, P.C. | Community/Behavioral Health | 4134 N Vancouver Avenue, Suite 102, Portland, OR 97217 | 2014-01-16 |
| 1417207994 | Sportland Acupuncture LLC | Acupuncturist | 1025 N Humboldt, Portland, OR 97217 | 2012-09-12 |
| Find all providers in zip 97217 | ||||
| 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.