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Denturist • Beaverton, OR

Active NPI 1629777552 Individual Practitioner Male Practitioner
Practice location in NPPES

4855 Sw Western Ave
Beaverton, OR 970053499

Call 5038132000 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

4855 Sw Western Ave

Beaverton, OR 970053499

Telephone 5038132000
Organization at the Same NPPES Address or Phone
Kaiser Foundation Health Plan Of The Northwest Facility NPI 1366497778

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

NPI first issued

2023

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, “Does 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Addresses are self-reported to NPPES and may be out of date.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 · Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-02-28
Denturist Primary Specialty

NUCC Taxonomy Code: 122400000X

License # reported to NPPES OR DT-DO-10222225

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.

Denturist

NUCC Taxonomy Code: 122400000X

License # reported to NPPES WA DN61216096

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.

Dental Laboratory Technician

NUCC Taxonomy Code: 126900000X

An individual who has the skill and knowledge in the fabrication of dental appliances, prostheses and devices in accordance with a dentist's laboratory work authorization. To avoid misleading the public, no occupational title other than dental laboratory technician or certified dental technician (when appropriate) should be used to describe this auxiliary.

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

Clinicians Sharing This Practice Address or Phone

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

24 listed
Amanda Andersen

Internal Medicine

NPI 1033504410
Dr. Shauyaun Azimi , DO

Psychiatry & Neurology - Child & Adolescent Psychiatry

NPI 1144755471

Doctor of Osteopathic Medicine (D.O.)

David Benjamin

Emergency Medicine

NPI 1134533839
Kyle Bowling

Nurse Anesthetist, Certified Registered

NPI 1063997898
Dr. Jennifer Brady , MD

Internal Medicine

NPI 1124288063

Doctor of Medicine (M.D.)

Ryan Cate , PA

Physician Assistant - Medical

NPI 1023211174

Physician Assistant

Career & Practice History

NPI enumerated February 28, 2023.

No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from March 2023 to August 2026.

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NPI Administrative Meta

NPI Number: 1629777552
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 28, 2023
Last Update: February 28, 2023
Sole Proprietor: No

Mailing Address

14820 Ne 74th Cir

Vancouver, WA 986825097

Phone: 3602815388

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.