PEDIATRIC DENTAL GROUP - NPI 1972770097

Q: What is the provider's specialty?

The provider's specialty is Dentist with taxonomy code 1223P0221X and a focus in Pediatric Dentistry.

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About Pediatric Dental Group NPPES

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

PEDIATRIC DENTAL GROUP (NPI 1972770097) is a healthcare organization registered as a pediatric dentistry in Portland, Oregon and active in the NPI registry since May 2008. The organization lists David J Cavano, Dentist, as its authorized official.

NPPES Registry Identity

NPI1972770097

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NamePEDIATRIC DENTAL GROUP

Location Address5415 SW WESTGATE DR, SUITE 207Portland, OR 97221-2409

Mailing Address5415 Sw Westgate Dr, Suite 207Portland, OR 97221-2409 · (503) 292-9274 · Fax (503) 292-2337

Phone(503) 292-9274

Fax(503) 292-2337

Organization SubpartNo

Authorized OfficialDavid J CavanoDentist · (503) 292-9274

Enumeration DateMay 8, 2008

✔ NPI 1972770097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers

Taxonomy Code1223P0221X

License✔ Licensed in OR · D7977

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

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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