MOUNTAINSIDE GENERAL DENTISTRY
NPI 1215104476
Dentist in Portland, OR

Q: What is Mountainside General Dentistry's NPI number?

The NPI number for Mountainside General Dentistry is 1215104476. It was assigned to this organization in the NPPES registry on May 15, 2008.

Q: What is Mountainside General Dentistry's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since May 15, 2008

3740 SE 122ND AVE, PORTLAND, OR 97236(503) 762-2525(503) 762-4872 Get Directions Write a Review

NPPES record last updated: May 15, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mountainside General Dentistry NPPES

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

MOUNTAINSIDE GENERAL DENTISTRY (NPI 1215104476) is a healthcare organization registered as a dentist in Portland, Oregon and active in the NPI registry since May 2008. The organization lists Lenore Supnet, Dentist, as its authorized official.

NPPES Registry Identity

NPI1215104476

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameMOUNTAINSIDE GENERAL DENTISTRY

Location Address3740 SE 122ND AVEPortland, OR 97236-3405

Mailing Address3740 Se 122nd AvePortland, OR 97236-3405 · (503) 762-2525 · Fax (503) 762-4872

Phone(503) 762-2525

Fax(503) 762-4872

Organization SubpartNo

Authorized OfficialLenore SupnetDentist · (503) 762-2525

Enumeration DateMay 15, 2008

✔ NPI 1215104476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in OR · D7895

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

3740 SE 122ND AVE, Portland, OR 97236

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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 3

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

ANTHONY M EL YOUSSEF DMD PC

Dentist

3740 SE 122ND AVE
PORTLAND, OR 97236

Multnomah County (503) 762-2525

MOUNTAINSIDE FAMILY DENTISTRY LLC

Dentist

3740 SE 122ND AVE
PORTLAND, OR 97236

Multnomah County (503) 762-2525

LENORE SUPNET D.M.D.

Dentist (General Practice)

3740 SE 122ND AVE
PORTLAND, OR 97236

Multnomah County (503) 762-2525

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 Mountainside General Dentistry's NPI number?

The NPI number for Mountainside General Dentistry is 1215104476. It was assigned to this organization in the NPPES registry on May 15, 2008.

Where is Mountainside General Dentistry located?

Mountainside General Dentistry is located at 3740 SE 122nd Ave, Portland, OR 97236. The listed phone number is (503) 762-2525.

What is Mountainside General Dentistry's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Mountainside General Dentistry was last updated on May 15, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.