<unavail> in Portland, OR - Medicare Clinic/Center

is a medicare enrolled dental clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Portland, Oregon. The current practice location for is 18633 Se Stark St Ste 401, Portland, Oregon. For appointments, you can reach them via phone at (503) 489-1760. The mailing address for is 18633 Se Stark St Ste 401, Portland, Oregon and phone number is (503) 489-1760.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1841592110. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (503) 489-1760.

Contact Information


	18633 Se Stark St Ste 401 Portland OR 97233-5468
	(503) 489-1760
	(503) 489-1763

Map and Direction

Dental Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	18633 Se Stark St Ste 401, Portland, Oregon
Authorized Official Name and Position	Lisa A. Cline (CHIEF EXECUTIVE OFFICER)
Authorized Official Contact	5034891760
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
18633 Se Stark St Ste 401 Portland OR 97233-5468 Ph: (503) 489-1760	18633 Se Stark St Ste 401 Portland OR 97233-5468 Ph: (503) 489-1760

NPI Details:

NPI Number	1841592110
Provider Enumeration Date	11/18/2010
Last Update Date	02/24/2022

Medicare PECOS Information:

Medicare PECOS PAC ID	2365680865
Medicare Enrollment ID	O20130522000417

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1841592110	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	(* (Not Available))	Secondary
124Q00000X	Dental Hygienist	(* (Not Available))	Secondary
207Q00000X	Family Medicine	(* (Not Available))	Secondary
261QC1500X	Clinic/center - Community Health	(* (Not Available))	Secondary
261QD0000X	Clinic/center - Dental	(* (Not Available))	Secondary
261QF0400X	Clinic/center - Federally Qualified Health Center (fqhc)	(* (Not Available))	Primary
363LF0000X	Nurse Practitioner - Family	(* (Not Available))	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	(* (Not Available))	Secondary

Reviews and Comments

Dental Clinics in Portland, OR

Kennedy Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3506 N Lombard St, Portland, OR 97217 Phone: 503-289-0230 Fax: 503-286-5055
Hayden Family Dentistry Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 732 Sw 3rd Ave, Suite 202, Portland, OR 97204 Phone: 503-541-2580
Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1904 Ne 45th Ave, Portland, OR 97213 Phone: 503-281-0866 Fax: 503-281-0867
Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 222 Nw 10th Ave, Portland, OR 97209 Phone: 503-546-9079 Fax: 503-546-5474
Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1238 Se 122nd Ave, Portland, OR 97233 Phone: 503-255-6815 Fax: 503-255-3044
Master Dental Smiles Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12661 Se Powell Blvd Ste C, Portland, OR 97236 Phone: 503-761-1900
Glenna K. Sequeira Dmd, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2440 Ne Fremont St, Portland, OR 97212 Phone: 503-249-8771 Fax: 503-249-8772

- Medicare Dental Clinic in Portland, OR