EASTSIDE PERIODONTICS & IMPLANTOLOGY
NPI 1063774784
Dentist - Periodontics in Portland, OR

Q: What is Laurissa Champion Dmd LLC's NPI number?

The NPI number for Laurissa Champion Dmd LLC is 1063774784. It was assigned to this organization in the NPPES registry on June 8, 2012. The provider is also known as Eastside Periodontics & Implantology.

Q: What is Laurissa Champion Dmd LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Active since June 08, 2012

2824 NE WASCO ST, SUITE 230, PORTLAND, OR 97232(503) 954-1372(503) 954-1392 Get Directions Write a Review

NPPES record last updated: June 8, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Eastside Periodontics & Implantology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EASTSIDE PERIODONTICS & IMPLANTOLOGY (NPI 1063774784) is a healthcare organization registered as a periodontics in Portland, Oregon and active in the NPI registry since June 2012. The organization lists Laurissa M Champion, Owner, as its authorized official.

NPPES Registry Identity

NPI1063774784

Entity TypeOrganization

Primary Taxonomy1223P0300X

Legal Business NameLAURISSA CHAMPION DMD LLC

Location Address2824 NE WASCO ST, SUITE 230Portland, OR 97232-1772

Mailing Address2824 Ne Wasco St, Suite 230Portland, OR 97232-1772 · (503) 954-1372 · Fax (503) 954-1392

Phone(503) 954-1372

Fax(503) 954-1392

Organization SubpartNo

Authorized OfficialLaurissa M ChampionOwner · (503) 954-1372

Enumeration DateJune 8, 2012

✔ NPI 1063774784 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

License✔ Licensed in OR · D8555

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

2824 NE WASCO ST, Portland, OR 97232

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Other Names 1

Other NameEastside Periodontics & Implantology

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL GREGORY PAGE

Dentist (Pediatric Dentistry)

2824 NE WASCO ST, SUITE 230
PORTLAND, OR 97232

Multnomah County (503) 284-5678

DR. THEODORE RASK D.M.D.

Dentist (General Practice)

2824 NE WASCO ST, SUITE 210
PORTLAND, OR 97232

Multnomah County (503) 284-3575

DEIRDRE FROEHLICH DMD LLC

Clinic/Center (Dental)

2824 NE WASCO ST, SUITE 200
PORTLAND, OR 97232

Multnomah County (503) 282-3884

PACIFIC NORTHWEST RENAL SERVICES, L.L.C.

Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)

2824 NE WASCO ST
PORTLAND, OR 97232

Multnomah County (503) 493-8227

DR. MONICA ANN KENNARD D.D.S.

Dentist (Pediatric Dentistry)

2824 NE WASCO ST
PORTLAND, OR 97232

Multnomah County (503) 284-5678

DR. DEIRDRE LEE FROEHLICH D.M.D.

Dentist (General Practice)

2824 NE WASCO ST, SUITE 200
PORTLAND, OR 97232

Multnomah County (503) 282-3884

DR. ANDREA NICOLE BELTZNER D.M.D.

Dentist (Pediatric Dentistry)

2824 NE WASCO ST, SUITE 230
PORTLAND, OR 97232

Multnomah County (503) 284-5678

DR. NOEL VEE LARSEN D.M.D.

Dentist (Pediatric Dentistry)

2824 NE WASCO ST
PORTLAND, OR 97232

Multnomah County (503) 284-5678

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Laurissa Champion Dmd LLC's NPI number?

The NPI number for Laurissa Champion Dmd LLC is 1063774784. It was assigned to this organization in the NPPES registry on June 8, 2012. The provider is also known as Eastside Periodontics & Implantology.

Where is Laurissa Champion Dmd LLC located?

Laurissa Champion Dmd LLC is located at 2824 NE Wasco St Suite 230, Portland, OR 97232. The listed phone number is (503) 954-1372.

What is Laurissa Champion Dmd LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Laurissa Champion Dmd LLC was last updated on June 8, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.