Brilliant Smile Dental, P.c. is a Dental Clinic in Portland, Oregon. It is located at 12720 Se Stark St, Portland, OR and its contact number is 503-252-6133. The authorized person for Brilliant Smile Dental, P.c. is Dr. Nicole Nga Luong
who is President of the clinic and their contact number is 503-708-8059. The primary license number for Brilliant Smile Dental, P.c. is D7803 (Dentist) in Oregon.
Brilliant Smile Dental, P.c. Clinic have dental surgeons who are specialized in dentistry, diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.
Complete Clinic Profile:
Brilliant Smile Dental, P.c. Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Brilliant Smile Dental, P.c. |
| Specialization: | Dentistry |
| Clinic Address: | 12720 Se Stark St, Portland,
Oregon, 97233-1539 |
| Phone: | 503-252-6133 |
| Fax: | 503-257-6886 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Nicole Nga Luong |
| Position: | President |
| Contact Number: | 503-708-8059 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Brilliant Smile Dental, P.c. clinic are as mentioned below.
| NPI Number: | 1215209861 |
| NPI Enumeration Date: | 28 Jan, 2012 |
| NPI Last Update On: | 31 Jan, 2014 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Brilliant Smile Dental, P.c. are as mentioned below.
| Specialization | License Number | State | Status | |
| Dentist | D7803 | Oregon | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 227117 | Medicaid | Oregon | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Brilliant Smile Dental, P.c.
12720 Se Stark St,
Portland, Oregon |
| Zip: | 97233-1539 |
| Phone Number: | 503-708-8059 |
| Fax Number: | -- |
Patients can reach Brilliant Smile Dental, P.c. at
12720 Se Stark St, Portland, Oregon or can
call to book an appointment on 503-252-6133.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.