Provider Demographics
NPI:1518350750
Name:GARFINKLE ORTHODONTICS
Entity type:Organization
Organization Name:GARFINKLE ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GARFINKLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:503-246-9802
Mailing Address - Street 1:1820 SW VERMONT ST
Mailing Address - Street 2:SUITE O
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-1945
Mailing Address - Country:US
Mailing Address - Phone:503-246-9802
Mailing Address - Fax:503-246-9995
Practice Address - Street 1:1820 SW VERMONT ST
Practice Address - Street 2:SUITE O
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-1945
Practice Address - Country:US
Practice Address - Phone:503-246-9802
Practice Address - Fax:503-246-9995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD45811223X0400X
ORA30227126800000X
ORD81951223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
No126800000XDental ProvidersDental AssistantGroup - Single Specialty