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DENTAL PROFESSIONAL
NPI 1356530422
Dentist - General Practice in Portland, OR

Active since October 15, 2007
15495 SW SEQUOIA PKWY, SUITE 120, PORTLAND, OR 97224(503) 684-8445 Get Directions Write a Review

NPPES record last updated: October 15, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dental Professional NPPES

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

DENTAL PROFESSIONAL (NPI 1356530422) is a healthcare organization registered as a general practice in Portland, Oregon and active in the NPI registry since October 2007. The organization lists Ken W Waddell, Owner, as its authorized official.

NPPES Registry Identity

NPI1356530422
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameKEN W. WADDELL, DMD P.C.
Location Address15495 SW SEQUOIA PKWY, SUITE 120Portland, OR 97224-6100
Mailing Address15495 Sw Sequoia Pkwy, Suite 120Portland, OR 97224-6100 · (503) 684-8445
Phone(503) 684-8445
Organization SubpartNo
Authorized OfficialKen W WaddellOwner · (503) 684-8445
Enumeration DateOctober 15, 2007
✔ NPI 1356530422 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in OR · D5796
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.
15495 SW SEQUOIA PKWY, Portland, OR 97224
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Other Names 1

Doing Business AsDental Professional

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 5

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

DR. KEN WAYNE WADDELL D.M.D.
Dentist (General Practice)
15495 SW SEQUOIA PKWY, SUITE 120
PORTLAND, OR 97224
Washington County (503) 684-8445
MR. BRIAN DARYL BUCKNER L.M.T.
Massage Therapist
15495 SW SEQUOIA PKWY, STE. #150
TIGARD, OR 97224
Washington County (503) 957-0338
AT EASE MASSAGE THERAPY, LLC
Mechanotherapist
15495 SW SEQUOIA PKWY, SUITE 150
TIGARD, OR 97224
Washington County (503) 957-0338
DR. DONALD WATSON RIRIE D.D.S.
Dentist (General Practice)
15495 SW SEQUOIA PKWY, SUITE 120
PORTLAND, OR 97224
Washington County (503) 684-8445
MS. ALISSA JOHNSON L.M.T., C.A.
Massage Therapist
15495 SW SEQUOIA PKWY
TIGARD, OR 97224
Washington County (503) 567-3456

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 Ken W. Waddell, Dmd P.C.'s NPI number?

The NPI number for Ken W. Waddell, Dmd P.C. is 1356530422. It was assigned to this organization in the NPPES registry on October 15, 2007. The provider is doing business as Dental Professional.

Where is Ken W. Waddell, Dmd P.C. located?

Ken W. Waddell, Dmd P.C. is located at 15495 SW Sequoia Pkwy Suite 120, Portland, OR 97224. The listed phone number is (503) 684-8445.

What is Ken W. Waddell, Dmd P.C.'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 Ken W. Waddell, Dmd P.C. was last updated on October 15, 2007. 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.