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ESTACADA FAMILY DENTAL, LLC
NPI 1366059768
Dentist - General Practice in Estacada, OR

Active since September 29, 2020
630 N BROADWAY ST, ESTACADA, OR 97023(503) 630-4218 Get Directions Write a Review

NPPES record last updated: September 29, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Estacada Family Dental, Llc NPPES

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

ESTACADA FAMILY DENTAL, LLC (NPI 1366059768) is a healthcare organization registered as a general practice in Estacada, Oregon and active in the NPI registry since September 2020. The organization lists Cornelius Gehred, President, as its authorized official.

NPPES Registry Identity

NPI1366059768
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameESTACADA FAMILY DENTAL, LLC
Location Address630 N BROADWAY STEstacada, OR 97023-8584
Mailing AddressPo Box 929Estacada, OR 97023-0929
Phone(503) 630-4218
Organization SubpartNo
Authorized OfficialCornelius GehredPresident · (503) 630-4218
Enumeration DateSeptember 29, 2020
NPPES CertifiedSeptember 29, 2020
✔ NPI 1366059768 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.
630 N BROADWAY ST, Estacada, OR 97023
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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.

DR. EDWIN CHARLES THORESON D.M.D.
Dentist (General Practice)
630 N BROADWAY ST
ESTACADA, OR 97023
Clackamas County (503) 630-4219
DR. SCOTT CHAPMAN CARTWRIGHT D.D.S.
Dentist
630 N BROADWAY ST
ESTACADA, OR 97023
Clackamas County (503) 630-4218
PAUL S HANSEN D.M.D.
Dentist (General Practice)
630 N BROADWAY ST, PO BOX 929
ESTACADA, OR 97023
Clackamas County (503) 630-4218

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 Estacada Family Dental, LLC's NPI number?

The NPI number for Estacada Family Dental, LLC is 1366059768. It was assigned to this organization in the NPPES registry on September 29, 2020.

Where is Estacada Family Dental, LLC located?

Estacada Family Dental, LLC is located at 630 N Broadway St, Estacada, OR 97023. The listed phone number is (503) 630-4218.

What is Estacada Family Dental, LLC'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 Estacada Family Dental, LLC was last updated on September 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.