Skip to content
NPISignal

Organization

Icp Teledentistry

NPI Record: ActiveDentist — Dental Public Health
NPI1225771108
Portland, Oregon

Provider's NPPES record last updated: April 18, 2022

Overview

Entity Type
Organization
NPI
1225771108
Primary Specialty
Dentist — Dental Public Health
Practice Location
Portland, Oregon
Organization Subpart
No

Federal Screening

NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.

List of Excluded Individuals/Entities (LEIE)

HHS Office of Inspector General

No potential match identified

No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.

Source data
September 10, 2026
Records indexed
84,001
Screened
Sep 19, 2026, 3:27 AM UTC

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

SAM.gov Exclusions

U.S. General Services Administration

Not checked

SAM.gov Exclusions was not checked.

SAM.gov screening is not configured on this deployment. No SAM check has been performed.

Screened
Not checked

This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

Run a name-based screening

Searches OIG LEIE and SAM.gov by name and reviews every potential match.

Specialties & Taxonomies

  • Dentist

    Dental Public Health

    Dental Providers

    Primary

    The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis.

    Taxonomy code 1223D0001X
  • Dental Hygienist

    Dental Providers

    An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary.

    Taxonomy code 124Q00000X
  • Dental Therapist

    Dental Providers

    A Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the relevant state board or a tribal entity to provide services within the scope of their practice under the supervision of a dentist. Functions that may be delegated to the dental therapist vary based on the needs of the dentist, the educational preparation of the dental therapist and state dental practice acts and regulations.

    Taxonomy code 125J00000X
  • Dental Assistant

    Dental Providers

    An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary.

    Taxonomy code 126800000X
  • Clinic/Center

    Dental

    Ambulatory Health Care Facilities

    Definition to come...

    Taxonomy code 261QD0000X
  • Clinic/Center

    Oral and Maxillofacial Surgery

    Ambulatory Health Care Facilities

    The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

    Taxonomy code 261QS0112X

Practice Locations

Practice Location

3439 Se Hawthorne Blvd # 906

Portland, Oregon 97214-5048

Phone: (425) 494-0883

Record Information

Enumeration Date
April 18, 2022
Provider's NPPES Record Last Updated
April 18, 2022
Certification Date
April 18, 2022
NPISignal NPPES Dataset
August 2026

See Something Wrong?

Incorrect provider information

Everything on this page comes directly from the NPPES data CMS publishes. NPISignal cannot edit a provider's record — only the provider or organization can, directly through NPPES.

Update a record through NPPES

Something wrong with this page?

If NPISignal is displaying this data incorrectly — a formatting error, a broken link, a mismatch with the source file — let us know.

Report a display issue