1. Home
  2. Directory
  3. Oregon
  4. Portland
  5. Dentist
  6. NPI Profile

MS. MACKENZIE E DOUGLAS D.M.D.
NPI 1639192693
Dentist - General Practice in Portland, OR

Active since July 25, 2006PECOS Enrolled
7615 SW CAPITOL HWY, PORTLAND, OR 97219(503) 244-3712(503) 244-2122 Get Directions Write a Review

NPPES record last updated: January 21, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Mackenzie E Douglas D.m.d. NPPES

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

MS. MACKENZIE E DOUGLAS D.M.D. (NPI 1639192693) is an individual general practice provider in Portland, Oregon, licensed in Oregon (D8647) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Lake Oswego.

NPPES Registry Identity

NPI1639192693
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameMS. MACKENZIE E DOUGLASCredential: D.M.D.
Location Address7615 SW CAPITOL HWYPortland, OR 97219-2436
Mailing Address7615 Sw Capitol HwyPortland, OR 97219-2436 · (503) 244-3712 · Fax (503) 244-2122
Phone(503) 244-3712
Fax(503) 244-2122
Sole ProprietorYes
Enumeration DateJuly 25, 2006
Last NPPES UpdateJanuary 21, 2021
NPPES CertifiedJanuary 21, 2021
✔ NPI 1639192693 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 · D8647
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.
7615 SW CAPITOL HWY, Portland, OR 97219
Open in Google Maps ↗

Secondary Practice Location 1

Location 19 Monroe Pkwy Ste CLake Oswego, OR 97035-8855 · Phone (503) 635-3431 · Fax (503) 635-2306

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Mackenzie E Douglas D.m.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97219 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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. KRISTAN DYAN RODRIGUEZ D.D.S.
Dentist (General Practice)
7615 SW CAPITOL HWY
PORTLAND, OR 97219
Multnomah County (503) 244-3712
MATTIE MARIE MORRIS RDH, BSDH
Dental Hygienist
7615 SW CAPITOL HWY
PORTLAND, OR 97219
Multnomah County (503) 244-3712
BETH M SHEPPARD RDH, BSDH
Dental Hygienist
7615 SW CAPITOL HWY
PORTLAND, OR 97219
Multnomah County (503) 244-3712

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 Mackenzie Douglas's NPI number?

The NPI number for Mackenzie Douglas is 1639192693. It was assigned to this individual provider in the NPPES registry on July 25, 2006.

Where is Mackenzie Douglas located?

Mackenzie Douglas practices at 7615 SW Capitol Hwy, Portland, OR 97219. The listed phone number is (503) 244-3712.

What is Mackenzie Douglas's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Mackenzie Douglas enrolled in Medicare?

Yes. Mackenzie Douglas is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mackenzie Douglas was last updated on January 21, 2021. 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.