Gresham Pediatric Dentistry is a Pediatric Dental Clinic in Gresham, Oregon. It is located at 831 Nw Council Dr Ste 210, Gresham, OR and its contact number is 503-666-9436. The authorized person for Gresham Pediatric Dentistry is Jiyoung Lee
who is Owner of the clinic and their contact number is 503-666-9436. The primary license number for Gresham Pediatric Dentistry is D8776 (Pediatric Dentistry) in Oregon. Gresham Pediatric Dentistry Clinic provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Clinic Profile:
Gresham Pediatric Dentistry Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Gresham Pediatric Dentistry
Specialization:
Pediatric Dentistry
Clinic Address:
831 Nw Council Dr Ste 210, Gresham, Oregon, 97030-3724
Phone:
503-666-9436
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:
Jiyoung Lee
Position:
Owner
Contact Number:
503-666-9436
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 Gresham Pediatric Dentistry clinic are as mentioned below.
NPI Number:
1942573118
NPI Enumeration Date:
17 Feb, 2012
NPI Last Update On:
23 Jun, 2020
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Gresham Pediatric Dentistry are as mentioned below.
Specialization
License Number
State
Status
Pediatric Dentistry
D8776
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
028475
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.
Patients can reach Gresham Pediatric Dentistry at 831 Nw Council Dr Ste 210, Gresham, Oregon or can call to book an appointment on 503-666-9436. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 November, 2024.