OrganizationActive
Summit Oregon LLC
NPI 1205664844 · Oral & Maxillofacial Surgery (D.M.D.) · Portland, OR
Provider details
- NPI number
- 1205664844
- Entity type
- Organization
- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)Allopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Prashant Charugundla, Oral & Maxillofacial Surgeon(503) 548-2006
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3332 N Lombard St Ste C
Portland, OR 97217-1258
Phone: (503) 548-2006
Fax: (503) 548-2012
Approximate (ZIP-level) locationGet directions
Mailing address
3332 N Lombard St Ste C
Portland, OR 97217-1258
Other names (DBA / former)
- Doing business as
- Summit Oral Surgery
- Doing business as
- Summit Oral Surgery
Registry dates
- Enumerated
- 2024-07-24
- Last updated
- 2026-04-06
- Certified
- 2026-04-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.