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Contact Information

MID VALLEY DENTAL OF BRIDGEPORT
7110 SW HAZEL FERN ROAD
SUITE 240
TIGARD, OR97224
 Phone: 503-431-3200
 Fax: 503-431-3210
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for MID VALLEY DENTAL OF BRIDGEPORT

NPI Number 1174348759
LBN Legal business name MID VALLEY DENTAL OF BRIDGEPORT
Authorized official GEOFFREY BERG - (OWNER/DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 11/19/2024
Last updated 11/19/2024 - More than a year ago
Identifiers n/a
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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