COLUMBIA PARK ORAL SURGERY PC
NPI 1639103658
Dentist - Oral and Maxillofacial Surgery in Portland, OR

Q: What is Columbia Park Oral Surgery PC's NPI number?

The NPI number for Columbia Park Oral Surgery PC is 1639103658. It was assigned to this organization in the NPPES registry on July 10, 2006.

Q: What is Columbia Park Oral Surgery PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Active since July 10, 2006

3549 N LOMBARD, PORTLAND, OR 97217(503) 289-9621(503) 289-2930 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Columbia Park Oral Surgery Pc NPPES

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

COLUMBIA PARK ORAL SURGERY PC (NPI 1639103658) is a healthcare organization registered as an oral and maxillofacial surgery in Portland, Oregon and active in the NPI registry since July 2006. The organization lists Jan A Kooning, President, as its authorized official.

NPPES Registry Identity

NPI1639103658

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameCOLUMBIA PARK ORAL SURGERY PC

Location Address3549 N LOMBARDPortland, OR 97217-5901

Mailing Address3549 N LombardPortland, OR 97217-5901 · (503) 289-9621 · Fax (503) 289-2930

Phone(503) 289-9621

Fax(503) 289-2930

Organization SubpartNo

Authorized OfficialJan A KooningPresident · (503) 289-9621

Enumeration DateJuly 10, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1639103658 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in OR · D6081

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

3549 N LOMBARD, Portland, OR 97217

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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

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

MR. JAN ANDREW KOONING DMD PC

Dentist (Oral and Maxillofacial Surgery)

3549 N LOMBARD
PORTLAND, OR 97217

Multnomah County (503) 289-9621

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 Columbia Park Oral Surgery PC's NPI number?

The NPI number for Columbia Park Oral Surgery PC is 1639103658. It was assigned to this organization in the NPPES registry on July 10, 2006.

Where is Columbia Park Oral Surgery PC located?

Columbia Park Oral Surgery PC is located at 3549 N Lombard, Portland, OR 97217. The listed phone number is (503) 289-9621.

What is Columbia Park Oral Surgery PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Columbia Park Oral Surgery PC was last updated on August 22, 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.