Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jantzen Beach Modern Dentistry, PC

Organization General Practice Dentistry · NPI 1558792051

Jantzen Beach Modern Dentistry, PC is a General Practice Dentistry in Portland, Oregon. Registered with an NPI since 2013.

In the registry since
2013
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12239 N Center Ave
Portland, OR 97217-7806
Phone: (503) 241-1800
Fax: (503) 241-1807
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1558792051
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Todd Cockrell — Owner · (503) 241-1800
Other names Jantzen Beach Modern Dentistry
NPI enumeratedDecember 9, 2013
Last updated in NPPESDecember 9, 2013
Mailing address17000 Red Hill Ave, Irvine, CA 92614-5626

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