Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Jeffrey Jacky , DENTURIST LD

Denturist β€’ Beaverton, OR

Active NPI 1356791677 Individual Practitioner Male Practitioner
Practice location in NPPES

4925 Sw Griffith Dr
Beaverton, OR 970052923

Call 8554336825 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

4925 Sw Griffith Dr

Beaverton, OR 970052923

Telephone 8554336825
Organization at the Same NPPES Address or Phone
Willettedental Facility NPI 1710317482

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 2 distinct additional practice-address records in Portland, OR; Salem, OR. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2016

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Beaverton and Oregon

5 active clinicians are listed under Denturist with a practice address in Beaverton, OR (126 in Oregon).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-06-26
Denturist Primary Specialty

NUCC Taxonomy Code: 122400000X

License # reported to NPPES OR DTDO709602

A denturist is a licensed professional that serves patients with removable dental prosthetic oral health needs. A licensed denturist is trained in removable dental prosthetics and the fabrication of such devices.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oregon Medical Board.
Look Up on State Board Site

Secondary Practice Locations

3490 Lancaster Dr Ne

Salem, OR 973051356

Phone: 8554336825

8931 Se Foster Rd

Portland, OR 972664661

Phone: 8554336825

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

22 listed
Dr. Eric Alston , DMD

Dentist - General Practice

NPI 1194165878

Doctor of Dental Medicine

NPI 1124530043

Doctor of Dental Surgery

NPI 1033464524

Doctor of Dental Medicine

Dr. Thao Chu , DDS

Dentist - General Practice

NPI 1033213657

Doctor of Dental Surgery

Dr. Elisabeth Gorman , DMD

Dentist - General Practice

NPI 1063988558

Doctor of Dental Medicine

NPI 1053818625

Doctor of Dental Surgery

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

13 Historical Events
πŸ“
Updated Practice Location December 30, 2022

Registered at 4925 SW GRIFFITH DR, BEAVERTON, OR 970052923 (Tel: 8554336825)

πŸ“
Updated Business Mailing Address December 30, 2022

Registered at 6950 NE CAMPUS WAY, HILLSBORO, OR 971245611 (Tel: 8554336825)

βœ…
NPI Profile Active September 29, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location September 29, 2017

Registered at 5935 SE ALEXANDER ST, HILLSBORO, OR 971238575 (Tel: 8554336825)

πŸ“
Updated Business Mailing Address September 29, 2017

Registered at 6950 NE CAMPUS WAY, HILLS BORO, OR 97124

πŸ‘€
Provider Name / Credentials Updated September 29, 2017

Recorded as JEFFREY JACKY, DENTURIST LD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 29, 2017

Denturist (license number reported to NPPES: OR DTDO709602)

βœ…
NPI Profile Active June 17, 2016

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) June 17, 2016

Registered at 822 NE 181ST AVE, PORTLAND, OR 972306708 (Tel: 5036015220)

πŸ“
Business Mailing Address (Initial Record) June 17, 2016

Registered at 822 NE 181ST AVE, PORTLAND, OR 972306708

πŸ‘€
Provider Name / Credentials (Initial Record) June 17, 2016

Recorded as JEFFREY JACKY, DENTURIST LD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 17, 2016

Denturist (license number reported to NPPES: OR DTDO709602)

🟒
Initial NPI Registration & Enumeration June 17, 2016

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1356791677
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 17, 2016
Last Update: June 26, 2023
Sole Proprietor: Yes

Mailing Address

6950 Ne Campus Way

Hillsboro, OR 971245611

Phone: 8554336825

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.