Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1841736634 Individual Practitioner Male Practitioner

Dr. Dmitry Keysalov , DDS

Dentist • Tualatin, OR

Professional Overview & Biography Verified Profile Summary

Dr. Dmitry Keysalov, DDS is a registered healthcare professional specializing in Dentist in Tualatin, OR. Practice services are available at 7017 SW NYBERG ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

7017 Sw Nyberg St

Tualatin, OR 970626243

Telephone 5036128736
Associated Practice Facility / Clinic
🏢 Tualatin Modern Dentistry,pc Facility NPI 1437499852

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Tualatin, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.2 Yrs
Regional Practice Density
14 Specialists

Practicing in Tualatin, 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

CMS Verified: 2024-10-09
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License OR D11923

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

3 Associated Practitioners
Irene Ko , RDH

Dental Hygienist

NPI 1376972059

Registered Dental Hygienist

NPI 1457104366
NPI 1538776315

Doctor of Dental Medicine

Career & Practice History Timeline

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

10 Historical Events
📍
Updated Practice Location October 09, 2024

Registered at 7017 SW NYBERG ST, TUALATIN, OR 970626243 (Tel: 5036128736)

📍
Updated Business Mailing Address October 09, 2024

Registered at 6682 SW BRISBAND ST, WILSONVILLE, OR 970706905 (Tel: 7579956725)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 09, 2024

Dentist (License #D11923 in OR)

📍
Updated Practice Location April 02, 2024

Registered at 9605 GRAND RONDE RD, GRAND RONDE, OR 973479712 (Tel: 5038792020)

NPI Profile Active January 17, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location January 17, 2017

Registered at 1074 GRAND OAK LN, VIRGINIA BEACH, VA 234557218 (Tel: 6467251252)

📍
Updated Business Mailing Address January 17, 2017

Registered at 1074 GRAND OAK LN, VIRGINIA BEACH, VA 234557218 (Tel: 6467251252)

👤
Provider Name / Credentials Updated January 17, 2017

Recorded as DMITRY KEYSALOV, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 17, 2017

Dentist (License #0401415490 in VA)

🟢
Initial NPI Registration & Enumeration January 17, 2017

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: 1841736634
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 17, 2017
Last Update: October 09, 2024
Sole Proprietor: No

Mailing Address

6682 Sw Brisband St

Wilsonville, OR 970706905

Phone: 7579956725

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.