OrganizationActive
Jantzen Beach Modern Dentistry, PC
NPI 1558792051 · General Practice Dentistry · Portland, OR
Jantzen Beach Modern Dentistry, PC is a General Practice Dentistry organization in Portland, OR (NPI 1558792051).
Provider details
- NPI number
- 1558792051
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Todd Cockrell, Owner(503) 241-1800
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 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
12239 N Center Ave
Portland, OR 97217-7806
Phone: (503) 241-1800
Fax: (503) 241-1807
Street-level locationGet directions
Mailing address
17000 Red Hill Ave
Irvine, CA 92614-5626
Other names (DBA / former)
- Doing business as
- Jantzen Beach Modern Dentistry
Registry dates
- Enumerated
- 2013-12-09
- Last updated
- 2013-12-09
Frequently asked questions
- What is Jantzen Beach Modern Dentistry, PC's NPI number?
- Jantzen Beach Modern Dentistry, PC's National Provider Identifier (NPI) is 1558792051, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jantzen Beach Modern Dentistry, PC?
- Jantzen Beach Modern Dentistry, PC is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is Jantzen Beach Modern Dentistry, PC located?
- Jantzen Beach Modern Dentistry, PC's practice location on file with NPPES is 12239 N Center Ave, Portland, OR 97217-7806.
- What is Jantzen Beach Modern Dentistry, PC's phone number?
- The practice phone number listed in the NPPES registry for Jantzen Beach Modern Dentistry, PC is (503) 241-1800.
- Who is the authorized official for Jantzen Beach Modern Dentistry, PC?
- The authorized official listed on Jantzen Beach Modern Dentistry, PC's NPPES record is Todd Cockrell, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jantzen Beach Modern Dentistry, PC's NPI active?
- Yes — Jantzen Beach Modern Dentistry, PC's NPI (1558792051) is active in the NPPES registry as of the last update on 2013-12-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.