IndividualActive
Kody Crook, DMD
NPI 1114651460 · General Practice Dentistry · Portland, OR
Provider details
- NPI number
- 1114651460
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- No
- License
- D11634 (OR)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5071 Ne 122nd Ave
Portland, OR 97230-1003
Phone: (503) 255-5700
Street-level locationGet directions
Mailing address
5809 Se 29th Ter
Gresham, OR 97080-8608
Additional practice locations (1)
- 36840 Industrial WaySandy, OR 97055-9254Phone: (503) 668-1300
Registry dates
- Enumerated
- 2022-07-13
- Last updated
- 2022-07-13
- Certified
- 2022-07-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.