MR. MATTHEW EDWARD BOURG DMD
NPI 1902994312
Dentist in Portland, OR

NPI Status: Active since October 11, 2006

Contact Information

17236 SE STARK ST
PORTLAND, OR
ZIP 97233
Phone: (503) 254-1260
Fax: (503) 254-1494

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
NPI Validation
Frequently Asked Questions

Individual
Male
Dentist
Accepts Insurance

About MATTHEW BOURG

This page provides the complete NPI Profile along with additional information for Matthew Bourg, a provider established in Portland, Oregon with a medical specialization in Dentist. The healthcare provider is registered in the NPI registry with number 1902994312 assigned on October 2006. The practitioner's primary taxonomy code is 122300000X with license number D6261 (OR). The provider is registered as an individual and his NPI record was last updated 18 years ago.

NPI: 1902994312
Provider Name: MR. MATTHEW EDWARD BOURG DMD
Gender: Male
Entity Type: Individual
Location Address: 17236 SE STARK ST PORTLAND, OR 97233
Location Phone: (503) 254-1260
Location Fax: (503) 254-1494
Mailing Address: 17236 SE STARK ST PORTLAND, OR 97233
Mailing Phone: (503) 254-1260
Mailing Fax: (503) 254-1494
Is Sole Proprietor?: No
Enumeration Date: 10-11-2006
Last Update Date: 07-08-2007
Code Navigator

A dentist like Matthew Bourg is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Dentist
Taxonomy Code: 122300000X
Type: Dental Providers
License No.: D6261
License State: OR
Taxonomy Description: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Antidote Health Plan of Arizona, Inc.

Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
Bronze Standard - HMO
Catastrophic Standard - HMO
Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
Gold Standard - HMO
Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
Silver Standard - HMO

Antidote Health Plan of Ohio, Inc.

Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
Bronze Standard - HMO
Catastrophic Standard - HMO
Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
Gold Standard - HMO
Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
Silver Standard - HMO

Blue Cross and Blue Shield of Alabama

Blue HSA Bronze - PPO
Blue Protect - PPO
Blue Saver Bronze - PPO
Blue Value Gold - PPO
Blue Value Silver - PPO
Blue Access Gold for Business - PPO
Blue Choice Platinum for Business - PPO
Blue HSA Silver for Business - PPO
Blue Saver Bronze for Business - PPO
Blue Saver Gold for Business - PPO
Blue Secure Gold for Business - PPO
Blue Secure Silver for Business - PPO

Blue Cross and Blue Shield of Illinois

BlueCare Dental 4 Kids? 1A - PPO
BlueCare Dental 4 Kids? 1B - PPO
BlueCare Dental? 1A - PPO
BlueCare Dental? 1B - PPO
BlueCare Dental? 1C - PPO
BlueCare Dental? 1D - PPO

Blue Cross and Blue Shield of Montana

BlueCare Dental 4 Kids? 1A - PPO
BlueCare Dental 4 Kids? 1B - PPO
BlueCare Dental? 1A - PPO
BlueCare Dental? 1B - PPO
BlueCare Dental? 1C - PPO
BlueCare Dental? 1D - PPO

Blue Cross and Blue Shield of Oklahoma

BlueCare Dental 4 Kids? 1A - PPO
BlueCare Dental 4 Kids? 1B - PPO
BlueCare Dental? 1A - PPO
BlueCare Dental? 1B - PPO
BlueCare Dental? 1C - PPO
BlueCare Dental? 1D - PPO

Blue Cross and Blue Shield of Texas

BlueCare Dental 1D - PPO
BlueCare Dental 4 Kids? 1A - PPO
BlueCare Dental 4 Kids? 1B - PPO
BlueCare Dental? 1A - PPO
BlueCare Dental? 1B - PPO
BlueCare Dental? 1C - PPO

BridgeSpan Health Company

BridgeSpan Standard Bronze Plan - EPO
BridgeSpan Standard Gold Plan - EPO
BridgeSpan Standard Silver Plan - EPO

Delta Dental Plan of Oregon

Delta Dental EPO - EPO
Delta Dental PPO - PPO
Delta Dental PPO MAC - PPO

Dominion National

Choice PPO Basic - PPO
Choice PPO Basic Kids - PPO
Choice PPO Plus - PPO
Choice PPO Premium - PPO
Choice PPO Premium Kids - PPO
Choice PPO Preventive - PPO

Florida Combined Life

BlueDental Copayment Q - PPO
BlueDental Copayment QF - PPO

Humana

Humana Dental Smart Choice - PPO
Humana Dental Smart Choice - High - PPO
Humana Dental Smart Choice - Lite - PPO
Humana Dental Smart Choice - Low - PPO
Humana Dental Smart Choice Basic - PPO
Humana Dental Smart Choice- Lite - PPO

Paramount

Paramount Dental Essential Plus Plan - EPO
Paramount Dental Preventive Family Plan - EPO
Paramount Dental Total Care Plan - EPO

Paramount Dental

HRI Essential Plus Plan - HMO
HRI Essential Plus Plan - PPO
HRI Preventive Family Plan - HMO
HRI Preventive Family Plan - PPO
HRI Total Care Plan - HMO
HRI Total Care Plan - PPO

Regence BlueCross BlueShield of Oregon

Bronze Essential 8500 With 4 Copay No Deductible Office Visits Individual and Family Network - EPO
Bronze HSA 7000 Individual and Family Network - EPO
Gold 2300 Individual and Family Network - EPO
Gold 2300 Legacy - EPO
Regence Standard Bronze Plan Individual and Family Network - EPO
Regence Standard Bronze Plan Legacy - EPO
Regence Standard Gold Plan Individual and Family Network - EPO
Regence Standard Gold Plan Legacy - EPO
Regence Standard Silver Plan Individual and Family Network - EPO
Regence Standard Silver Plan Legacy - EPO
Silver 6200 Individual and Family Network - EPO
Silver 6200 Legacy - EPO

Renaissance Dental

Alabama Preferred Plan - PPO
Alabama Preferred Plan (Pediatric Only) - PPO
Alabama Preferred Plus Plan - PPO
Alabama Preferred Plus Plan (Pediatric Only) - PPO
Alabama Wellness Essentials Plan - PPO
Florida Preferred Plan - PPO
Florida Preferred Plan (Pediatric Only) - PPO
Florida Preferred Plus Plan - PPO
Florida Preferred Plus Plan (Pediatric Only) - PPO
Florida Wellness Essentials Plan - PPO
High PPO Dental Plan - PPO
High PPO Dental Plan (Pediatric Only) - PPO
Kansas Preferred Plan - PPO
Kansas Preferred Plan (Pediatric Only) - PPO
Kansas Wellness Essentials Plan - PPO
Low PPO Dental Plan - PPO
Low PPO Dental Plan (Pediatric Only) - PPO
Mississippi Preferred Plan - PPO
Mississippi Preferred Plan (Pediatric Only) - PPO
Mississippi Wellness Essentials Plan - PPO

UnitedHealthcare

Smile Now Arizona - No Waiting Period PPO - PPO
Smile Now Illinois - No Waiting Period PPO - PPO
Smile Now Michigan - No Waiting Period PPO - PPO
Smile Now Ohio - No Waiting Period PPO - PPO
Smile Now Tennessee - No Waiting Period PPO - PPO
Smile Now Texas- No Waiting Period Plan - PPO
Smile Now Utah - No Waiting Period PPO - PPO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
117721	MEDICAID (05)	OR

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	9	0	2	9	9	4	3	1	2
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	9	0	2	18	9	8	3	2
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 0 + 2 + 1 + 8 + 9 + 8 + 3 + 2 + 24 = 68
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 68 = 2									2

The NPI number 1902994312 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.