- Practice location
- 7420 SW Bridgeport RD Ste 104, Tigard, OR 97224-7790
- Phone
- 503-430-7909
- Fax
- 503-268-1501
- Last updated
- February 15, 2012
Bridgeport Family Dental, LLC is a healthcare organization based in Tigard, OR. Bridgeport Family Dental, LLC practices in Tigard, OR. The NPI Number for Bridgeport Family Dental, LLC is 1740553106 and holds a License No. D7482 (OR). The current practice location address for Bridgeport Family Dental, LLC is 7420 SW Bridgeport RD Ste 104, Tigard, OR 97224-7790 and can be reached out via phone at 503-430-7909 and via fax at 503-268-1501.
Provider Profile Details
- NPI Number
- 1740553106
- Provider Name
- Bridgeport Family Dental, LLC
- Provider Entity Type
- Organization
- Address
- 7420 SW Bridgeport RD Ste 104, Tigard, OR 97224-7790
- Phone Number
- 503-430-7909
- Fax Number
- 503-268-1501
- Primary Taxonomy
- Dentist · 122300000X
- Organization Subpart
- No
- Authorized Official
- Dr. Kelly Jean Johnson, DDS · Owner/Dentist · 503-430-7909
- Provider Enumeration Date
- February 15, 2012
- Last Update Date
- February 15, 2012
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 7420 SW Bridgeport RD Ste 104
Tigard, OR 97224-7790 - City
- Tigard
- State
- Oregon
- Zip
- 97224-7790
- Phone Number
- 503-430-7909
- Fax Number
- 503-268-1501
Provider Business Mailing Address Details
- Address
- 7420 SW Bridgeport RD Ste 104
Tigard, OR 97224-7790 - City
- Tigard
- State
- OR
- Zip
- 97224-7790
- Phone Number
- 503-430-7909
- Fax Number
- 503-268-1501
License Information
- License Number
- D7482
- License State
- OR
- Taxonomy
- Dentist · 122300000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Dentists near Tigard, OR
View all Dentists in Tigard →Frequently Asked Questions
What is the NPI number of Bridgeport Family Dental, LLC?
The NPI number of Bridgeport Family Dental, LLC is 1740553106. It was assigned on February 15, 2012 and is currently active in the NPPES registry.
What is the specialty of Bridgeport Family Dental, LLC?
Bridgeport Family Dental, LLC is registered under the primary taxonomy Dentist (code 122300000X), licensed in OR under license number D7482.
Where does Bridgeport Family Dental, LLC practice?
The practice location is 7420 SW Bridgeport RD Ste 104, Tigard, OR 97224-7790. The office can be reached at 503-430-7909 (phone) or 503-268-1501 (fax).
What is an NPI number?
A National Provider Identifier (NPI) 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). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1740553106 directly on the NPPES registry website.