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WAGGONER DENTISTRY PC
NPI 1093646085
Dentist - Pediatric Dentistry in Lake Oswego, OR

Active since May 27, 2026
15962 BOONES FERRY RD STE 208, LAKE OSWEGO, OR 97035(503) 292-9274 Get Directions Write a Review

NPPES record last updated: May 27, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Waggoner Dentistry Pc NPPES

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

WAGGONER DENTISTRY PC (NPI 1093646085) is a healthcare organization registered as a pediatric dentistry in Lake Oswego, Oregon and active in the NPI registry since May 2026. The organization lists Tesha Waggoner, Owner, as its authorized official.

NPPES Registry Identity

NPI1093646085
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameWAGGONER DENTISTRY PC
Location Address15962 BOONES FERRY RD STE 208Lake Oswego, OR 97035-4360
Mailing Address5415 Sw Westgate Dr Ste 207Portland, OR 97221-2429 · (503) 292-9274
Phone(503) 292-9274
Organization SubpartNo
Authorized OfficialTesha WaggonerOwner · (503) 292-9274
Enumeration DateMay 27, 2026
NPPES CertifiedMay 27, 2026
✔ NPI 1093646085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Definition
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.
15962 BOONES FERRY RD STE 208, Lake Oswego, OR 97035
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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

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

MATTHEW M SHEPPARD D.M.D L.L.C.
Dentist (General Practice)
15962 BOONES FERRY RD STE 208
LAKE OSWEGO, OR 97035
Clackamas County (503) 636-8154

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 Waggoner Dentistry PC's NPI number?

The NPI number for Waggoner Dentistry PC is 1093646085. It was assigned to this organization in the NPPES registry on May 27, 2026.

Where is Waggoner Dentistry PC located?

Waggoner Dentistry PC is located at 15962 Boones Ferry Rd Ste 208, Lake Oswego, OR 97035. The listed phone number is (503) 292-9274.

What is Waggoner Dentistry PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Waggoner Dentistry PC was last updated on May 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.