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Active NPI 1043057334 Individual Practitioner Female Practitioner

Dr. Serena Autumn Waterworth-West , DMD

Dentist - General Practice • Gresham, OR

Professional Overview & Biography Verified Profile Summary

Dr. Serena Waterworth-West, DMD is a registered healthcare professional specializing in Dentist - General Practice in Gresham, OR. Practice services are available at 387 NE 223RD AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

387 Ne 223rd Ave

Gresham, OR 970308554

Telephone 5034915450
Associated Practice Facility / Clinic
🏢 Gresham Modern Dentistry, Pc Facility NPI 1760728786

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Gresham, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 20.0 Yrs
State Avg: 13.7 Yrs
Regional Practice Density
43 Specialists

Practicing in Gresham, OR (1994 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-05-12
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License OR D12035

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
NPI 1114405859

Doctor of Dental Surgery

Dr. Robert Kowal , DDS

Dentist - General Practice

NPI 1285902619

Doctor of Dental Surgery

NPI 1629797485

Doctor of Dental Medicine

Dr. Jaime Holtz , DDS

Dentist - General Practice

NPI 1821519505

Doctor of Dental Surgery

NPI 1841860483

Doctor of Dental Medicine

NPI 1922483346

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
👤
Provider Name / Credentials Updated May 12, 2026

Recorded as SERENA WATERWORTH-WEST, DMD

NPI Profile Active July 12, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location July 12, 2024

Registered at 387 NE 223RD AVE, GRESHAM, OR 970308554 (Tel: 5034915450)

📍
Updated Business Mailing Address July 12, 2024

Registered at 1268 NE 186TH DR, PORTLAND, OR 972307127 (Tel: 5035300609)

👤
Provider Name / Credentials Updated July 12, 2024

Recorded as SERENA WATERWORTH, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 12, 2024

Dentist (License #D12035 in OR)

🟢
Initial NPI Registration & Enumeration July 12, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1043057334
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 12, 2024
Last Update: May 12, 2026
Sole Proprietor: No

Mailing Address

1268 Ne 186th Dr

Portland, OR 972307127

Phone: 5035300609

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.