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BILLI ODEGAARD DENTAL CLINIC
NPI 1871843078
Clinic/Center - Federally Qualified Health Center (FQHC) in Portland, OR

Active since September 14, 2012
33 NW BROADWAY, STE 380, PORTLAND, OR 97209(503) 988-5770(503) 988-5442 Get Directions Write a Review

NPPES record last updated: May 18, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 18, 2024, Mar 12, 2019, Feb 27, 2018 (3 updates tracked since 2018).

About Billi Odegaard Dental Clinic NPPES

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

BILLI ODEGAARD DENTAL CLINIC (NPI 1871843078) is a healthcare organization registered as a federally qualified health center (fqhc) in Portland, Oregon and active in the NPI registry since September 2012. The organization lists Derrick Moten, Interim Business Services Director, as its authorized official.

NPPES Registry Identity

NPI1871843078
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameBILLI ODEGAARD DENTAL CLINIC
Location Address33 NW BROADWAY, STE 380Portland, OR 97209-3580
Mailing Address619 Nw 6th Ave Ste 500Portland, OR 97209-3964 · (503) 988-7468 · Fax (503) 988-3015
Phone(503) 988-5770
Fax(503) 988-5442
Organization SubpartYesParent: Multnomah County
Authorized OfficialDerrick MotenInterim Business Services Director · (503) 988-2966
Enumeration DateSeptember 14, 2012
Last NPPES UpdateMay 18, 20243 updates tracked since enumeration
NPPES CertifiedMay 18, 2024
✔ NPI 1871843078 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedClinic/Center · DentalTaxonomy 261QD0000X
33 NW BROADWAY, Portland, OR 97209
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Other Identifiers 2

Medicaid096511OR
Medicaid022959OR

Other Providers at the Same Location NPPES 20

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

JEFFREY M MOORE LPC, CADC I
Counselor (Mental Health)
33 NW BROADWAY
PORTLAND, OR 97209
Multnomah County (503) 228-7134
SAMANTHA DUFFARD
Peer Specialist
33 NW BROADWAY
PORTLAND, OR 97209
Multnomah County (503) 228-7134
DAVID CROUSE
Counselor (Addiction (Substance Use Disorder))
33 NW BROADWAY
PORTLAND, OR 97209
Multnomah County (503) 228-7134
KAELI HARWOOD LCSW
Social Worker (Clinical)
33 NW BROADWAY
PORTLAND, OR 97209
Multnomah County (503) 228-7134
AUBREY ALVARADO
Counselor (Mental Health)
33 NW BROADWAY
PORTLAND, OR 97209
Multnomah County (503) 228-7134
PHILIP JOHN DEGRAFFENREID
Counselor (Mental Health)
33 NW BROADWAY
PORTLAND, OR 97209
Multnomah County (503) 228-7134
MR. JEREMY HUTSON RN
Registered Nurse
33 NW BROADWAY
PORTLAND, OR 97209
Multnomah County (503) 228-7134
KYLE STILWELL
Counselor (Mental Health)
33 NW BROADWAY
PORTLAND, OR 97209
Multnomah County (503) 228-7134

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 Billi Odegaard Dental Clinic's NPI number?

The NPI number for Billi Odegaard Dental Clinic is 1871843078. It was assigned to this organization in the NPPES registry on September 14, 2012.

Where is Billi Odegaard Dental Clinic located?

Billi Odegaard Dental Clinic is located at 33 NW Broadway Ste 380, Portland, OR 97209. The listed phone number is (503) 988-5770.

What is Billi Odegaard Dental Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

When was this NPI record last updated?

The NPPES record for Billi Odegaard Dental Clinic was last updated on May 18, 2024. 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.