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Active NPI 1508416041 Organization (Entity Type 2)

Columbia River Dentistry-Gresham, Llc

Clinic/Center - Dental • Gresham, OR

About Columbia River Dentistry-Gresham, Llc NPI 1508416041 Summary

Columbia River Dentistry-Gresham, Llc is a verified healthcare organization specializing in Clinic/Center - Dental operating in Gresham, OR. Located at 1700 NW CIVIC DR STE 320, this facility provides patient care and medical services under National Provider Identifier (NPI) 1508416041.

Administrative operations and authorized compliance are overseen by Debbie Lopez (Regional Manager).

Facility Location & Contact Primary Location

Facility Address

1700 Nw Civic Dr Ste 320

Gresham, OR 970303774

Telephone 5036665200

Authorized Official Information

Authorized Contact Name

Debbie Lopez

Title / Role

Regional Manager

Official Telephone

5039148221

Facility Classifications & Specialties

Clinic/Center - Dental Primary Taxonomy

NUCC Taxonomy Code: 261QD0000X

Definition to come...

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events

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NPI Profile Active September 17, 2019

NPI status registered as active in NPPES database

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Updated Practice Location September 17, 2019

Registered at 1700 NW CIVIC DR STE 320, GRESHAM, OR 970303774 (Tel: 5036665200)

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Updated Business Mailing Address September 17, 2019

Registered at 1700 NW CIVIC DR STE 320, GRESHAM, OR 970303774 (Tel: 5036665200)

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Organization / Clinic Name Updated September 17, 2019

Operating as COLUMBIA RIVER DENTISTRY-GRESHAM, LLC

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 17, 2019

Clinic/Center

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Initial NPI Registration & Enumeration September 17, 2019

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

Verified patient ratings, healthcare experiences, and facility photos

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NPI Organization Metadata

NPI Number: 1508416041

Entity Type:

Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)

Enumeration Date: September 17, 2019

Last Update: September 17, 2019

Update or Correct Listing

Mailing Address

1700 Nw Civic Dr Ste 320

Gresham, OR 970303774

Phone: 5036665200

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.

⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.