GLISAN DENTAL OFFICE
NPI 1073065207
Dentist - General Practice in Portland, OR

Q: What is the provider's specialty?

The provider's specialty is Dentist with taxonomy code 1223G0001X and a focus in General Practice.

Active since November 04, 2016

10102 NE GLISAN ST, PORTLAND, OR 97220(800) 813-2000(503) 286-6879 Get Directions Write a Review

NPPES record last updated: June 1, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 1, 2021, Nov 4, 2016 (2 updates tracked since 2016).

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About Glisan Dental Office NPPES

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

GLISAN DENTAL OFFICE (NPI 1073065207) is a healthcare organization registered as a general practice in Portland, Oregon and active in the NPI registry since November 2016. The organization lists Kenneth R Wright, Vp Dental Care Services, as its authorized official.

NPPES Registry Identity

NPI1073065207

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameKAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST

Location Address10102 NE GLISAN STPortland, OR 97220-4456

Mailing Address500 Ne Multnomah StPortland, OR 97232-2023 · (800) 813-2000 · Fax (503) 286-6879

Phone(800) 813-2000

Fax(503) 286-6879

Organization SubpartYesParent: Kaiser Permanente Dental Care Program

Authorized OfficialKenneth R WrightVp Dental Care Services · (503) 813-4660

Enumeration DateNovember 4, 2016

Last NPPES UpdateJune 1, 20212 updates tracked since enumeration

NPPES CertifiedJune 1, 2021

✔ NPI 1073065207 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Definition

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.

10102 NE GLISAN ST, Portland, OR 97220

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Other Names 1

Other NameGlisan Dental Office

Group Practice 1

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