PEDIATRIC DENTAL GROUP (NPI# 1972770097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972770097 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTAL GROUP |
| Practice Address |
5415 Sw Westgate Dr Suite 207 Portland OR 97221-2409 |
| Practice Telephone | 5032929274 |
| Practice Fax Number | 5032922337 |
| Mailing Telephone | 5032929274 |
| Mailing Fax Number | 5032922337 |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2008-05-08 |
| Authorized Official Name | DR. DAVID J CAVANO (DENTIST) |
| Authorized Official Telephone | 5032929274 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D7977 | OR | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447700497 | Pediatric Dental Group | Point of Service | 38 Sw Cutoff, Northborough, MA 01532-2159 | 2016-10-13 |
| 1376946244 | Pediatric Dental Group | Dentist | 5518 Lake Howell Rd, Winter Park, FL 32792-1036 | 2014-10-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Pediatric Dental Group at Kids First, PC | 96 Wadsworth Blvd., Suite B, Lakewood, CO 80226 |
| Colorado Business Entities | Pediatric Dental Group of Arvada, PC | 7975 Allison Way, Arvada, CO 80005 |
| Colorado Business Entities | Pediatric Dental Group of Colorado, PLLC | 7975 Allison Way, Arvada, CO 80005 |
| Colorado Business Entities | Pediatric Dental Group of Lakewood, PC | 3333 W. Wadsworth Blvd, #b104, Lakewood, CO 80227 |
| Colorado Business Entities | Pediatric Dental Group of Summit County, PC | 360 Peak One Dr, Frisco, CO 80443 |
| Colorado Business Entities | Pediatric Dental Group of Wheat Ridge, PC | Medical Office Building Iv, 3555 Lutheran Parkway, Suite 310, Wheat Ridge, CO 80033 |
| Oklahoma Business Registrations | PEDIATRIC DENTAL GROUP, LLC | 602 S Utica, Tulsa, OK 74104 |
| Street Address |
5415 SW WESTGATE DR SUITE 207 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97221-2409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306843669 | Richard I. Park | Dentist | 5415 Sw Westgate Dr, Suite 207, Portland, OR 97221-2409 | 2005-07-01 |
| 1689912701 | Quayanna Marie Kane | Dental Hygienist | 5415 Sw Westgate Dr, Portland, OR 97221-2409 | 2013-01-24 |
| 1720387566 | Dan R Nafziger L P T P C | Clinic/Center | 5415 Sw Westgate Dr, Suite Ll3, Portland, OR 97221-2409 | 2011-03-18 |
| 1215117734 | Dan Ray Nafziger | Physical Therapist | 5415 Sw Westgate Dr, Suite Ll3, Portland, OR 97221-2409 | 2007-11-13 |
| 1811046758 | Jukka J. Perkiomaki | Dentist | 5415 Sw Westgate Dr, 202, Portland, OR 97221-2409 | 2007-01-09 |
| 1275641284 | Jay Preston Malmquist | Dentist | 5415 Sw Westgate Dr, Suite #l-7, Portland, OR 97221-2409 | 2006-08-29 |
| 1841308863 | Stephen Patrick Clemens | Dentist | 5415 Sw Westgate Dr, Suite L-7, Portland, OR 97221-2409 | 2006-08-29 |
| 1821053521 | Roger Brent Lawrence | Dentist | 5415 Sw Westgate Dr, Suite 206, Portland, OR 97221-2409 | 2006-04-18 |
| 1538160973 | Steven John Scheffel | Dentist | 5415 Sw Westgate Dr, Ste. 206, Portland, OR 97221-2409 | 2005-08-09 |
| 1518964840 | David J. Cavano | Dentist | 5415 Sw Westgate Dr, Suite 207, Portland, OR 97221-2409 | 2005-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407460371 | Samantha Nozomi Murata | Pharmacist | 5415 Sw Beaverton Ct Hwy, Portland, OR 97221 | 2020-09-08 |
| 1063996312 | Maximilian Torres | Physical Therapy Assistant | 4602 Sw 53rd Ave, Portland, OR 97221 | 2018-09-22 |
| 1275071599 | Kayla Hoskins | Social Worker | 6443 Sw Beaverton Hillsdale Hwy Suite 300, Portland, OR 97221 | 2017-02-07 |
| 1467821520 | Tam Nguyen | Pharmacist | 5431 Sw Beaverton Hillsdale, Portland, OR 97221 | 2015-09-18 |
| 1124494786 | Laine Towell | Psychologist | 6443 Sw Beaverton Hillsdale Hwy Ste 300, Portland, OR 97221 | 2015-08-18 |
| 1376936633 | Patricia A. Lolich-beyer | Counselor | 5201 Sw Westgate Dr., Suite 118, Portland, OR 97221 | 2015-03-11 |
| 1134468374 | Alexandra Scamarone | Acupuncturist | 5319 Sw Westgate Dr, Unit No. 150, Portland, OR 97221 | 2013-02-07 |
| 1508118316 | Nichole C. Marks | Speech-Language Pathologist | 6125 Sw Boundary, Portland, OR 97221 | 2012-10-04 |
| 1649529538 | Navkiran Kaur Singh | Counselor | 5440 Sw Westgate Drive., Suite 175, Portland, OR 97221 | 2012-09-06 |
| 1306124276 | Alyssa C. Brin | Counselor | 5440 Sw Westgate Dr Ste 210, Portland, OR 97221 | 2011-07-26 |
| Find all providers in zip 97221 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700374154 | Fox Kids Dentistry & Orthodontics II | Dentist | 1401 Se Morrison St Ste 120, Portland, OR 97214-2777 | 2018-05-01 |
| 1679924526 | Pediatric Dentistry of Portland LLC | Dentist | 2811 Ne Wasco St, Portland, OR 97232-1771 | 2016-06-22 |
| 1801183488 | World of Smiles, Pediatric Dentistry LLC | Dentist | 11790 Sw Barnes Rd Ste 280, Portland, OR 97225-5935 | 2011-07-05 |
| 1265696629 | Angela Dawn Boydston | Dentist | 2824 Ne Wasco St Ste 230, Portland, OR 97232-1772 | 2008-07-15 |
| 1972639623 | Anastacia M. Whitman | Dentist | 4548 N Albina Ave, Portland, OR 97217-3010 | 2007-02-26 |
| 1114088705 | Michael Biermann | Dentist | 5900 N Lombard St, Portland, OR 97203-4118 | 2006-12-13 |
| 1053408005 | Peter John Lax | Dentist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2006-10-09 |
| 1376646901 | Krista V Badger Dds PC | Dentist | 3839 Ne Tillamook St, Portland, OR 97212-5338 | 2006-09-07 |
| 1902827199 | Karole H Wilson D.m.d., PC | Dentist | 9370 Sw Greenburg Rd Ste T, Portland, OR 97223-5408 | 2006-07-22 |
| 1083650436 | Susan J Russett-collett | Dentist | 888 Brighton Ave, Portland, ME 04102-1004 | 2006-06-22 |
| 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.