EVERGREEN SMILES
NPI 1205628104
Dentist - General Practice in Dallas, OR

Q: What is Evergreen Smiles's NPI number?

The NPI number for Evergreen Smiles is 1205628104. It was assigned to this organization in the NPPES registry on May 19, 2025.

Q: What is Evergreen Smiles's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Evergreen Smiles was last updated on May 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since May 19, 2025

289 E ELLENDALE AVE STE 201, DALLAS, OR 97338(770) 876-5404 Get Directions Write a Review

NPPES record last updated: May 19, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Evergreen Smiles NPPES

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

EVERGREEN SMILES (NPI 1205628104) is a healthcare organization registered as a general practice in Dallas, Oregon and active in the NPI registry since May 2025. The organization lists Tanner Weeks, Owner/dentist, as its authorized official.

NPPES Registry Identity

NPI1205628104

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameEVERGREEN SMILES

Location Address289 E ELLENDALE AVE STE 201Dallas, OR 97338-1541

Mailing Address7015 Riva Ridge Dr SeTurner, OR 97392-9455

Phone(770) 876-5404

Organization SubpartNo

Authorized OfficialTanner WeeksOwner/dentist · (770) 876-5404

Enumeration DateMay 19, 2025

NPPES CertifiedMay 19, 2025

✔ NPI 1205628104 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.

289 E ELLENDALE AVE STE 201, Dallas, OR 97338

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Other Identifiers 1

Medicaid1881433670UT

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

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 Evergreen Smiles's NPI number?

The NPI number for Evergreen Smiles is 1205628104. It was assigned to this organization in the NPPES registry on May 19, 2025.

Where is Evergreen Smiles located?

Evergreen Smiles is located at 289 E Ellendale Ave Ste 201, Dallas, OR 97338. The listed phone number is (770) 876-5404.

What is Evergreen Smiles's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Evergreen Smiles was last updated on May 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.