Icp Teledentistry

NPI #1225771108 in Portland, Oregon

Provider Information

NPI Number: 1225771108
Entity Type: Organization
Organization Name: Icp Teledentistry
Primary Specialty: Dentist - Dental Public Health
Enumeration Date: Apr 18, 2022
Last Updated: Apr 18, 2022

Practice Location

Address: 3439 SE HAWTHORNE BLVD # 906
City: Portland
State: Oregon
ZIP Code: 97214-5048
Phone: (425) 494-0883

Authorized Official

Name: MR. CHANDAN SHARMA
Title: HOD
Phone: (425) 494-0883

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X
Dental Therapist	125J00000X
Dental Assistant	126800000X
Clinic/Center - Dental — Dental	261QD0000X
Clinic/Center - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	261QS0112X
Dentist - Dental Public Health — Dental Public Health	1223D0001X	Primary

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DR. Alexander Gregory Brodsky, DMD	Dentist - Dental Public Health	Portland	AI Deep Dive
Rita Jean Hartlley, DMD	Dentist - Dental Public Health	Portland	AI Deep Dive
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Organizations

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Dental Outreach Oregon	Dentist - Dental Public Health	Portland	AI Deep Dive

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