Portland Dental LLC

NPI #1124583208 in Portland, Oregon

Provider Information

NPI Number: 1124583208
Entity Type: Organization
Organization Name: Portland Dental LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 4, 2019
Last Updated: Feb 4, 2019

Practice Location

Address: 511 SW 10TH AVE STE 1206
City: Portland
State: Oregon
ZIP Code: 97205-2713
Phone: (503) 227-1693

Authorized Official

Name: DR. KAVEENDRA THUSHARA RANASINGHE, DMD
Title: PARTNER/GENERAL DENTIST
Phone: (503) 227-1693

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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