MASTER DENTAL SMILES INC NPI 1003442518

Dentist (General Practice) in Portland, OR

Organization Dentist General Practice

About MASTER DENTAL SMILES INC

Master Dental Smiles Inc is a provider established in Portland, Oregon specializing in dentist (general practice) . The NPI number of Master Dental Smiles Inc is 1003442518 and was assigned on March 2020. The practitioner's primary taxonomy code is 1223G0001X. The provider is registered as an organization and their NPI record was last updated March 2020. Master Dental Smiles Inc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is James Robert Edwards (Dentist)

NPI

1003442518

Provider NameMASTER DENTAL SMILES INC
Provider Location Address12661 SE POWELL BLVD STE C PORTLAND, OR 97236
Provider Mailing Address12661 SE POWELL BLVD STE C PORTLAND, OR 97236
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date03-16-2020
Last Update Date03-16-2020

Primary Taxonomy

Taxonomy Code1223G0001X
ClassificationDentist
TypeDental Providers
SpecializationGeneral Practice
Taxonomy DescriptionA 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.

Business Address

MASTER DENTAL SMILES INC
12661 SE POWELL BLVD STE C
PORTLAND, OR
ZIP 97236
Phone: (503) 761-1900

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Mailing Address

MASTER DENTAL SMILES INC
12661 SE POWELL BLVD STE C
PORTLAND, OR
ZIP 97236
Phone: (503) 761-1900

Authorized Official

Authorized Official Name JAMES ROBERT EDWARDS
Authorized Official TitleDENTIST
Authorized Official Phone(503) 761-1900

Group Taxonomy


193200000X MULTI-SPECIALTY GROUP - This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1265067615 IVAN JOHN KONKIN
Individual
Denturist12661 SE POWELL BLVD STE C
PORTLAND, OR 97236
(503) 655-4007
1639198021 JAMES ROBERT EDWARDS DDS
Individual
Dentist (General Practice)12661 SE POWELL BLVD STE C
PORTLAND, OR 97236
(503) 761-1900

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.