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Deactivated NPI 1811961030 Deactivated / Inactive NPI Male Practitioner

Dr. Philip Rettew Dougherty , DMD

Dentist • Portland, OR

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Philip Dougherty has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 14, 2006
NPI Deactivation Date June 14, 2022
Total Practice Duration ~16 Years of Practice (2006 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Philip Dougherty, DMD was a registered Dentist practicing in Portland, OR. Throughout an active medical career spanning 16 years, Dr. Dougherty provided care at the practice location at 7615 SW CAPITOL HWY until profile deactivation on 2022-06-14.

Practice Location & Contact Primary Location

Practice Address

7615 Sw Capitol Hwy

Portland, OR 972192436

Telephone 5032443712
Fax 5032442122

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Portland, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 15.7 Yrs
State Avg: 13.2 Yrs
Regional Practice Density
283 Specialists

Practicing in Portland, OR (1289 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

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License OR D3435

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

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

4 Associated Practitioners
Dr. Kristan Rodriguez , DDS

Dentist - General Practice

NPI 1366966533

Doctor of Dental Surgery

NPI 1518209816

Registered Dental Hygienist, BSDH

Dr. Mackenzie Douglas , DMD

Dentist - General Practice

NPI 1639192693

Doctor of Dental Medicine

NPI 1881030138

Registered Dental Hygienist, BSDH

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated June 14, 2022

Record deactivated on June 14, 2022

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 7615 SW CAPITOL HWY, PORTLAND, OR 972192436 (Tel: 5032443712)

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Updated Business Mailing Address July 08, 2007

Registered at 7615 SW CAPITOL HWY, PORTLAND, OR 972192436 (Tel: 5032443712)

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Provider Name / Credentials Updated July 08, 2007

Recorded as PHILIP DOUGHERTY, DMD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #D3435 in OR)

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Initial NPI Registration & Enumeration February 14, 2006

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: 1811961030
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 14, 2006
Last Update: July 08, 2007
Deactivation Date: June 14, 2022

Mailing Address

7615 Sw Capitol Hwy

Portland, OR 972192436

Phone: 5032443712

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.