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

Active since October 11, 2006
17236 SE STARK ST, PORTLAND, OR 97233(503) 254-1260(503) 254-1494 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Matthew Edward Bourg Dmd NPPES

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

MR. MATTHEW EDWARD BOURG DMD (NPI 1902994312) is an individual dentist in Portland, Oregon, licensed in Oregon (D6261) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1902994312
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameMR. MATTHEW EDWARD BOURGCredential: DMD
Location Address17236 SE STARK STPortland, OR 97233-4546
Mailing Address17236 Se Stark StPortland, OR 97233-4546 · (503) 254-1260 · Fax (503) 254-1494
Phone(503) 254-1260
Fax(503) 254-1494
Sole ProprietorNo
Enumeration DateOctober 11, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1902994312 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in OR · D6261
Definition
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.
17236 SE STARK ST, Portland, OR 97233
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Other Identifiers 1

Medicaid117721OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

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 Matthew Bourg's NPI number?

The NPI number for Matthew Bourg is 1902994312. It was assigned to this individual provider in the NPPES registry on October 11, 2006.

Where is Matthew Bourg located?

Matthew Bourg practices at 17236 SE Stark St, Portland, OR 97233. The listed phone number is (503) 254-1260.

What is Matthew Bourg's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

What insurance does Matthew Bourg accept?

Health plans from Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BridgeSpan Health Company and 9 other insurers list Matthew Bourg as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Matthew Bourg was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.