Kaiser Permanente Dental Care Program

NPI #1861918005 in Portland, Oregon

Provider Information

NPI Number: 1861918005
Entity Type: Organization
Organization Name: Kaiser Permanente Dental Care Program
Subpart: Yes (part of a larger organization)
Parent Organization: KAISER FOUNDATION HEALTH PLAN OF THE NW
Primary Specialty: Dentist
Enumeration Date: Aug 18, 2017
Last Updated: Jun 1, 2021

Practice Location

Address: 2930 NE DEKUM ST
City: Portland
State: Oregon
ZIP Code: 97211-6613
Phone: (800) 813-2000

Authorized Official

Name: MRS. AMY MARKO
Title: DENTAL BUSINESS LEADER
Phone: (503) 813-4660

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X
Dentist	122300000X	Primary

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