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ROOTS DENTAL
NPI 1063993749
Clinic/Center - Dental in Portland, OR

Active since August 22, 2018
16338 SE STARK ST, PORTLAND, OR 97233(971) 294-1399 Get Directions Write a Review

NPPES record last updated: September 20, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 20, 2019, Aug 22, 2018 (2 updates tracked since 2018).

About Roots Dental NPPES

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

ROOTS DENTAL (NPI 1063993749) is a healthcare organization registered as a dental in Portland, Oregon and active in the NPI registry since August 2018. The organization lists Ryan Smith, Manager, as its authorized official.

NPPES Registry Identity

NPI1063993749
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameROOTS DENTAL STARK LLC
Location Address16338 SE STARK STPortland, OR 97233-3958
Mailing Address16338 Se Stark StPortland, OR 97233-3958 · (503) 912-2600
Phone(971) 294-1399
Organization SubpartNo
Authorized OfficialRyan SmithManager · (503) 912-2600
Enumeration DateAugust 22, 2018
Last NPPES UpdateSeptember 20, 20192 updates tracked since enumeration
✔ NPI 1063993749 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License✔ Licensed in OR · D9728
16338 SE STARK ST, Portland, OR 97233
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Other Names 1

Doing Business AsRoots Dental

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 Roots Dental Stark LLC's NPI number?

The NPI number for Roots Dental Stark LLC is 1063993749. It was assigned to this organization in the NPPES registry on August 22, 2018. The provider is doing business as Roots Dental.

Where is Roots Dental Stark LLC located?

Roots Dental Stark LLC is located at 16338 SE Stark St, Portland, OR 97233. The listed phone number is (971) 294-1399.

What is Roots Dental Stark LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Roots Dental Stark LLC was last updated on September 20, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.