Mountainside Family Dentistry Llc is a Dental Clinic in Portland, Oregon. It is located at 3740 Se 122nd Ave, Portland, OR and its contact number is 503-762-2525. The authorized person for Mountainside Family Dentistry Llc is Dr. Derek W. Conklin
who is Dentist/owner/ President of the clinic and their contact number is 503-762-2525. Other organizations associated with this clinic are Mountainside General Dentistry, Anthony M El Youssef Dmd Pc, Mountainside Family Dentistry Llc, The primary license number for Mountainside Family Dentistry Llc is D8325 (Dentist) in Oregon. Mountainside Family Dentistry Llc 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:
Mountainside Family Dentistry Llc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Mountainside Family Dentistry Llc
Specialization:
Dentistry
Clinic Address:
3740 Se 122nd Ave, Portland, Oregon, 97236-3405
Phone:
503-762-2525
Fax:
503-762-4872
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. Derek W. Conklin
Position:
Dentist/owner/ President
Contact Number:
503-762-2525
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 Mountainside Family Dentistry Llc clinic are as mentioned below.
NPI Number:
1295080836
NPI Enumeration Date:
19 Jul, 2012
NPI Last Update On:
19 Jul, 2012
Other Associated Organizations:
Other organizations which are associated with this clinic are as mentioned below. These organization share the same address but have similar or different specialization.
Speciality of these organizations are also mentioned below.
Name
Specialization
NPI Number
Mountainside General Dentistry
Dentistry
1215104476
Anthony M El Youssef Dmd Pc
Dentistry
1215598263
Mountainside Family Dentistry Llc
Dentistry
1295080836
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mountainside Family Dentistry Llc are as mentioned below.
Specialization
License Number
State
Status
Dentist
D8325
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
243185
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:
Mountainside Family Dentistry Llc 3740 Se 122nd Ave, Portland, Oregon
Zip:
97236-3405
Phone Number:
503-762-2525
Fax Number:
503-762-4872
Patients can reach Mountainside Family Dentistry Llc at 3740 Se 122nd Ave, Portland, Oregon or can call to book an appointment on 503-762-2525. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 September, 2024.