TESHA WAGGONER DMD PC
NPI 1790558997
Dentist - Pediatric Dentistry in Portland, OR

Q: What is Tesha Waggoner Dmd PC's NPI number?

The NPI number for Tesha Waggoner Dmd PC is 1790558997. It was assigned to this organization in the NPPES registry on October 31, 2023.

Q: What is Tesha Waggoner Dmd PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Active since October 31, 2023

5415 SW WESTGATE DR., SUITE 207, PORTLAND, OR 97221(503) 292-9274(503) 445-0043 Get Directions Write a Review

NPPES record last updated: October 31, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Tesha Waggoner Dmd Pc NPPES

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

TESHA WAGGONER DMD PC (NPI 1790558997) is a healthcare organization registered as a pediatric dentistry in Portland, Oregon and active in the NPI registry since October 2023. The organization lists Tesha Lynn Waggoner, Owner, as its authorized official.

NPPES Registry Identity

NPI1790558997

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NameTESHA WAGGONER DMD PC

Location Address5415 SW WESTGATE DR., SUITE 207Portland, OR 97221

Mailing Address5415 Sw Westgate Dr., Suite 207Portland, OR 97221 · (503) 292-9274 · Fax (503) 445-0043

Phone(503) 292-9274

Fax(503) 445-0043

Organization SubpartNo

Authorized OfficialTesha Lynn WaggonerOwner · (503) 292-9274

Enumeration DateOctober 31, 2023

✔ NPI 1790558997 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers

Taxonomy Code1223P0221X

Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

5415 SW WESTGATE DR., Portland, OR 97221

Open in Google Maps ↗

Other Identifiers 1

Medicaid500748806OR

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.

ALLIA SHELL

Counselor (Mental Health)

5415 SW WESTGATE DR.
PORTLAND, OR 97221

Multnomah County (503) 645-3581

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 Tesha Waggoner Dmd PC's NPI number?

The NPI number for Tesha Waggoner Dmd PC is 1790558997. It was assigned to this organization in the NPPES registry on October 31, 2023.

Where is Tesha Waggoner Dmd PC located?

Tesha Waggoner Dmd PC is located at 5415 SW Westgate Dr. Suite 207, Portland, OR 97221. The listed phone number is (503) 292-9274.

What is Tesha Waggoner Dmd PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Tesha Waggoner Dmd PC was last updated on October 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.