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PETERSON PERIODONTICS & IMPLANTOLOGY LLC
NPI 1801310008
Dentist - Periodontics in Portland, OR

Active since July 29, 2017
5528 SE POWELL BLVD, PORTLAND, OR 97206(503) 788-1008 Get Directions Write a Review

NPPES record last updated: July 29, 2017. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Peterson Periodontics & Implantology Llc NPPES

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

PETERSON PERIODONTICS & IMPLANTOLOGY LLC (NPI 1801310008) is a healthcare organization registered as a periodontics in Portland, Oregon and active in the NPI registry since July 2017. The organization lists Andrew Gregory Peterson, Periodontist, Member Of Llc, as its authorized official.

NPPES Registry Identity

NPI1801310008
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NamePETERSON PERIODONTICS & IMPLANTOLOGY LLC
Location Address5528 SE POWELL BLVDPortland, OR 97206-2956
Mailing Address4420 Se 51st AvePortland, OR 97206-3910 · (406) 861-8844
Phone(503) 788-1008
Organization SubpartNo
Authorized OfficialAndrew Gregory PetersonPeriodontist, Member Of Llc · (406) 861-8844
Enumeration DateJuly 29, 2017
✔ NPI 1801310008 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in OR · D9905
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
5528 SE POWELL BLVD, Portland, OR 97206
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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 4

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

DR. QUINN ROBERT HUMMEL DMD
Dentist (General Practice)
5528 SE POWELL BLVD
PORTLAND, OR 97206
Multnomah County (503) 788-1008
DEWEY DENTAL, P.C.
Dentist (General Practice)
5528 SE POWELL BLVD
PORTLAND, OR 97206
Multnomah County (503) 788-1008
DONALD H WHEELER DMD PC
Dentist
5528 SE POWELL BLVD
PORTLAND, OR 97206
Multnomah County (503) 788-1008
DR. WAYNE A VETTER DPM
Podiatrist
5528 SE POWELL BLVD
PORTLAND, OR 97206
Multnomah County (503) 777-3999

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 Peterson Periodontics & Implantology LLC's NPI number?

The NPI number for Peterson Periodontics & Implantology LLC is 1801310008. It was assigned to this organization in the NPPES registry on July 29, 2017.

Where is Peterson Periodontics & Implantology LLC located?

Peterson Periodontics & Implantology LLC is located at 5528 SE Powell Blvd, Portland, OR 97206. The listed phone number is (503) 788-1008.

What is Peterson Periodontics & Implantology LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Peterson Periodontics & Implantology LLC was last updated on July 29, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.