PROVIDENCE HEALTH & SERVICES - OREGON
NPI 1407109937
Oral & Maxillofacial Surgery in Portland, OR
NPI Status: Active since October 22, 2012
Contact Information
4805 NE GLISAN ST STE 11N
PORTLAND, OR
ZIP 97213
Phone: (503) 215-3053
Fax: (503) 215-3037
- Organization
- Oral & Maxillofacial Surgery
- Accepts Insurance
- Medicare Supplier
- Accepts Medicare Approved Payment
About PROVIDENCE HEALTH & SERVICES - OREGON
This page provides the complete NPI Profile along with additional information for Providence Health & Services - Oregon, a provider established in Portland, Oregon operating as a Oral & Maxillofacial Surgery. The healthcare provider is registered in the NPI registry with number 1407109937 assigned on October 2012. The practitioner's primary taxonomy code is 204E00000X. The provider is registered as an organization and their NPI record was last updated March 2026. The provider's
- NPI
- 1407109937
- Provider Legal Name
- PROVIDENCE HEALTH & SERVICES - OREGON
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 4805 NE GLISAN ST STE 11N PORTLAND, OR 97213
- Location Phone
- (503) 215-3053
- Location Fax
- (503) 215-3037
- Mailing Address
- PO BOX 31001 - 4180 PASADENA, CA 91110
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-22-2012
- Last Update Date
- 03-23-2026
- Code Navigator
Providence Health & Services - Oregon is a medicare supplier with PTAN 20483441 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Breast Prostheses and/or Accessories or Surgical Dressings or Lymphedema Compression Treatment Items.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Oral & Maxillofacial Surgery
- Taxonomy Code
- 204E00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Connect 1500 Gold - EPO
- Connect 6000 Silver - EPO
- Connect 9800 Bronze - EPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20483441
- Accepts Medicare Assignment
- YES
- Specialities List
- Medical Supply Company Other.
- Competitive Bidding
- NO
Supplies List
- Breast Prostheses and/or Accessories - Prosthetic bra, Surgical bra
- Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
- Lymphedema Compression Treatment Items -
Reviews for PROVIDENCE HEALTH & SERVICES - OREGON
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1407109937, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 63 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
PORTLAND, OR 97213
PORTLAND, OR 97213
PORTLAND, OR 97213
PORTLAND, OR 97213
PORTLAND, OR 97213
PORTLAND, OR 97213
PORTLAND, OR 97213
PORTLAND, OR 97213
PORTLAND, OR 97213
PORTLAND, OR 97213
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1407109937, enumerated as an "organization" on October 22, 2012.
The provider is located at 4805 NE GLISAN ST STE 11N PORTLAND, OR 97213 and the phone number is (503) 215-3053.
Oral & Maxillofacial Surgery with taxonomy code 204E00000X.
The provider might be accepting Accepts: Providence Health Plan. Please consult your insurance carrier or call the provider to verify.
