Tesha Waggoner Dmd Pc is a Pediatric Dental Clinic in Portland, Oregon. It is located at 5415 Sw Westgate Dr., Suite 207, Portland, OR and its contact number is 503-292-9274. The authorized person for Tesha Waggoner Dmd Pc is Dr. Tesha Lynn Waggoner
who is Owner of the clinic and their contact number is 503-292-9274.
Tesha Waggoner Dmd Pc 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:
Tesha Waggoner Dmd Pc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Tesha Waggoner Dmd Pc |
| Specialization: | Pediatric Dentistry |
| Clinic Address: | 5415 Sw Westgate Dr., Suite 207, Portland,
Oregon, 97221 |
| Phone: | 503-292-9274 |
| Fax: | 503-445-0043 |
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. Tesha Lynn Waggoner |
| Position: | Owner |
| Contact Number: | 503-292-9274 |
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 Tesha Waggoner Dmd Pc clinic are as mentioned below.
| NPI Number: | 1790558997 |
| NPI Enumeration Date: | 31 Oct, 2023 |
| NPI Last Update On: | 31 Oct, 2023 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Tesha Waggoner Dmd Pc are as mentioned below.
| Specialization | License Number | State | Status | |
| Pediatric Dentistry | | | 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 |
| 500748806 | 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: | Tesha Waggoner Dmd Pc
5415 Sw Westgate Dr., Suite 207
Portland, Oregon |
| Zip: | 97221 |
| Phone Number: | 503-292-9274 |
| Fax Number: | 503-445-0043 |
Patients can reach Tesha Waggoner Dmd Pc at
5415 Sw Westgate Dr., Suite 207, Portland, Oregon or can
call to book an appointment on 503-292-9274.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.