OrganizationActive
The Wallace Medical Concern
NPI 1558033118 · Dental Clinic/Center · Portland, OR
Provider details
- NPI number
- 1558033118
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Michelle Sirianni, Ea & Federal Grants Program Manager(503) 489-1760
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
18633 Se Stark St Ste 401
Portland, OR 97233-5468
Phone: (503) 489-1760
Street-level locationGet directions
Mailing address
18633 Se Stark St Ste 401
Portland, OR 97233-5468
Registry dates
- Enumerated
- 2021-10-01
- Last updated
- 2026-03-23
- Certified
- 2026-03-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.