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Contact Information

MARK E ENGELSTAD, MD, DDS
3181 SW SAM JACKSON PARK RD
PORTLAND, OR97239-3011
 Phone: 503-494-8914
 Fax: 503-494-0294
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral & Maxillofacial Surgery

204E00000X 02 Physician/General Surgery
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
Indicates primary specialty

NPI Profile & details for MARK E ENGELSTAD · (Male)

NPI # 1437102746
Status Active
Credentials MD, DDS
Entity Individual
Enumeration date 05/18/2006
Last updated 10/10/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • OR License # DF0023
  • OR License # MD153490
  • MN Medicaid 357147500
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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