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SOUTHEAST DENTAL CLINIC
NPI 1285136820
Clinic/Center - Federally Qualified Health Center (FQHC) in Portland, OR

Active since February 28, 2018
3653 SE 34TH AVE, PORTLAND, OR 97202(503) 988-4410 Get Directions Write a Review

NPPES record last updated: March 16, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 16, 2019, Feb 28, 2018 (2 updates tracked since 2018).

About Southeast Dental Clinic NPPES

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

SOUTHEAST DENTAL CLINIC (NPI 1285136820) is a healthcare organization registered as a federally qualified health center (fqhc) in Portland, Oregon and active in the NPI registry since February 2018. The organization lists Cammy Gaddis, Finance Specialist, as its authorized official.

NPPES Registry Identity

NPI1285136820
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameMULTNOMAH COUNTY
Location Address3653 SE 34TH AVEPortland, OR 97202-3034
Mailing Address619 Nw 6th Ave Ste 210Portland, OR 97209-3964 · (503) 988-7468
Phone(503) 988-4410
Organization SubpartYes
Authorized OfficialCammy GaddisFinance Specialist · (503) 988-7468
Enumeration DateFebruary 28, 2018
Last NPPES UpdateMarch 16, 20192 updates tracked since enumeration
✔ NPI 1285136820 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedClinic/Center · DentalTaxonomy 261QD0000X
3653 SE 34TH AVE, Portland, OR 97202
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Other Names 1

Doing Business AsSoutheast Dental Clinic

Other Identifiers 1

Medicaid022959OR

Other Providers at the Same Location NPPES 20

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

DR. ALEXANDER GREGORY BRODSKY DMD
Dentist (Dental Public Health)
3653 SE 34TH AVE
PORTLAND, OR 97202
Multnomah County (503) 988-4410
MS. ADRIENNE BROOKE REED RDH
Dental Hygienist
3653 SE 34TH AVE
PORTLAND, OR 97202
Multnomah County (503) 988-5558
MS. ALICIA JOY PLUMB D.D.S
Dentist (General Practice)
3653 SE 34TH AVE
PORTLAND, OR 97202
Multnomah County (503) 988-4410
MULTNOMAH COUNTY
Clinic/Center (Public Health, State or Local)
3653 SE 34TH AVE
PORTLAND, OR 97202
Multnomah County (503) 988-3663
CARLA REMESCHATIS CHW
Community Health Worker
3653 SE 34TH AVE
PORTLAND, OR 97202
Multnomah County (503) 988-6628
THERESA EMILY CHIAPPE
Internal Medicine
3653 SE 34TH AVE
PORTLAND, OR 97202
Multnomah County (503) 780-9522
MULTNOMAH COUNTY OREGON
Pharmacy (Clinic Pharmacy)
3653 SE 34TH AVE
PORTLAND, OR 97202
Multnomah County (503) 988-5423
DR. JEANINE LEA HERZOG DMD
Dentist (General Practice)
3653 SE 34TH AVE
PORTLAND, OR 97202
Multnomah County (503) 665-9616

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 Multnomah County's NPI number?

The NPI number for Multnomah County is 1285136820. It was assigned to this organization in the NPPES registry on February 28, 2018. The provider is doing business as Southeast Dental Clinic.

Where is Multnomah County located?

Multnomah County is located at 3653 SE 34th Ave, Portland, OR 97202. The listed phone number is (503) 988-4410.

What is Multnomah County's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

When was this NPI record last updated?

The NPPES record for Multnomah County was last updated on March 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.