OrganizationActive
Exceptional Needs Dental Services (ends)
NPI 1073676037 · Health Maintenance Organization · Portland, OR
Provider details
- NPI number
- 1073676037
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Authorized official
- Tonia Ayres, Administrator
- License
- 821498 (OR)
Practice location
12029 Ne Sumner St
Portland, OR 97220-9015
Phone: (503) 295-1201
Fax: (503) 295-1211
Mailing address
12029 Ne Sumner St
Portland, OR 97220-9015
Registry dates
- Enumerated
- 2006-12-19
- Last updated
- 2013-02-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.