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Contact Information

BEAVERTON DENTAL CENTER LLC
11673 SW BEAVERTON HILLSDALE HWY
BEAVERTON, OR97005-2928
 Phone: 503-641-4328
 Fax: 503-644-8454
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Denturist

122400000X
Indicates primary specialty

NPI Profile & details for BEAVERTON DENTAL CENTER LLC

NPI Number 1023367513
LBN Legal business name BEAVERTON DENTAL CENTER LLC
Authorized official JOHN WILLIAMS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/30/2012
Last updated 08/30/2012 - About 14 years ago
Identifiers
OR License # 2004
OR License # 27130
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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